by Jonathan Coe
‘Hello,’ I said. ‘I didn’t know what to get you, so I brought some grapes. Not very original.’
She took the mask off and smiled. Her lips were turning slightly blue.
‘They’re seedless,’ I added.
‘I’ll have some later.’
I held her hand, which was icy, and waited while she took some more breaths from the mask.
Fiona said: ‘They’re going to move me. To another ward.’
I said: ‘How come?’
She said: ‘Intensive care.’
I tried not to let the panic show in my face.
She said: ‘They did all these things to me this morning. It took about an hour. It was awful.’
I said: ‘What sort of things?’
She said: ‘First of all, I saw Dr Gillam. The registrar. She was very nice, but she seemed a bit angry about something. She made them do an X-ray here. Right away. I had to sit up in bed and they put this plate behind my back. Then I had to keep breathing in. That was quite bad. Then they wanted to do a blood gases test, so they got this needle and had to find an artery. Here.’ She showed me her wrist, which had several puncture marks. ‘I think it must be difficult to get it right first time.’
I said: ‘When are they moving you?’
She said: ‘Soon, I think. I don’t know what the delay is.’
I said: ‘Have they told you what’s wrong?’
She shook her head.
Dr Gillam took me aside into a private room. First of all she asked me if I was next of kin, and I said no, I was just a friend. She asked me how long I’d known Fiona and I said about four months, and she asked me if Fiona had any family and I said no, not unless there were uncles or cousins that I didn’t know about. Then I asked her why Fiona was suddenly so ill and she told me everything, starting with the pneumonia. She’d picked up a severe pneumonia from somewhere and her body wasn’t fighting it properly. The explanation for that lay in the X-rays (and, of course, in the consultant’s notes, locked up somewhere in a filing cabinet), which revealed large growths in the centre of her chest: a lymphoma, in fact. The word meant nothing to me so Dr Gillam explained that it was a form of cancer, and seemed, in this case, to be quite advanced.
‘How advanced?’ I said. ‘I mean, it’s not too late to do anything about this, is it?’
Dr Gillam was a tall woman whose jet-black hair was cut in a bob and whose small, gold-rimmed glasses framed a pair of striking and combative brown eyes. She thought carefully before answering.
‘If we could have got at this a bit earlier, we may have had a better chance.’ She gave the impression of holding something back, at this point. Like Fiona, I could sense a closely guarded anger. ‘As it is,’ she continued, ‘her blood oxygen level’s been allowed to get very low. The only thing we can do is move her to intensive care and keep a close eye on her.’
‘So what are you waiting for?’
‘Well, it’s not quite that simple. You see, first of all –’
I knew what was coming.
‘– we’ve got to find her a bed.’
∗
I stayed at the hospital until the bed was found. This time it only took about another half hour. It involved several telephone calls and appeared to depend, finally, on finding a patient two or three beds down the chain, throwing him off his ward and making him wait in the day room until he could be officially discharged. Then Fiona was taken away from me again and there was nothing I could do. I went home.
I didn’t have any medical books but the dictionaries I’d used for the crossword were still lying on the table, so I looked up ‘lymphoma’. All it said was ‘a tumour having the structure of a lymphatic gland’. Put like that it didn’t sound very frightening but apparently this was the cause of all those months of sore throats and fevers, and this was the reason her immune system had all but closed down and surrendered to the first infection that came its way. I stared at the word again, stared at it for so long that it stopped making any kind of sense and began to look like nothing but a meaningless jumble of letters. How could anything so small, so random as this silly little word possibly do so much damage? How could it (but this wasn’t going to happen) destroy a person?
It wasn’t going to happen.
Suddenly revolted by the sight of the half-finished crossword, which seemed trivial and offensive, I screwed the newspaper up into a ball and in the process knocked over the cold remains of my second cup of coffee. Then, after fetching a cloth and wiping away the stain, I fell into a frenzy of cleaning. I polished the table, dusted the shelves and attacked the skirting-board. I marshalled scourers and J-cloths, Pledge, Jif and Windolene. I went at it so ferociously that I started to take the paint off the window frames and the veneer off the coffee table. But even this wasn’t enough. I piled all the furniture from my sitting room into the hallway and vacuumed the carpet. I took a mop to the bathroom floor and polished the taps and the shower fittings and the mirrors. I cleaned out the lavatory bowl. Then I went round the flat with two big black dustbin liners, throwing in every out-of-date magazine, every wad of yellowing newsprint, every discarded note and scrap of paper. I didn’t stop until I came upon an unopened Jiffy bag, containing my parcel of books from the Peacock Press: then, seized by an absurd, almost hysterical curiosity, I tore it open and looked at the three volumes. I wanted to see something that would make me laugh.
There was a slender pamphlet entitled Architectural Beauties of Croydon, which boasted, according to the flyleaf, ‘three black and white illustrations’. Plinths! Plinths! Plinths!, by the Reverend J.W. Pottage, promised to be ‘the most accessible and humorous offering yet to fall from the pen of an author now internationally recognized as an authority in his field’. And the third book seemed to be yet another volume of war memoirs, bearing the somewhat enigmatic title, I Was ‘Celery’.
Before I’d had time to attach any significance to this, the telephone rang. I threw the book down at once and went to answer it. It was the hospital. They were putting Fiona on to a ventilator and if I wanted to talk to her I should come right away.
∗
‘There’s been a circulatory collapse,’ Dr Gillam explained. ‘We’ve been treating her with high concentrations of oxygen, but the level in her blood’s still very low. So we’ll have to try the ventilator. Once she’s on it, though, she won’t be able to talk. I thought you’d better see her first.’
She could barely talk even now.
She said: ‘I can’t understand it.’
And: ‘Thanks for being here.’
And: ‘You look tired.’
And: ‘What happened to the lasagne?’
I said: ‘You’ll be all right.’
And: ‘Are you comfortable?’
And: ‘The doctors here are very good.’
And: ‘You’ll be all right.’
It was nothing special, as conversations go. I suppose none of our conversations had ever been all that special. Especially special, I nearly wrote. I think I must be going to pieces.
∗
They said it would take about ninety minutes to set the ventilator up and fit all the necessary drips, and after that I could go back to see her. I lingered for a few minutes in the Relatives’ Room, a functional-enough waiting area with a few unyielding black vinyl chairs and a selection of newspapers and magazines which seemed slightly more upmarket than usual. Then I went to get a cup of coffee, and managed to find a canteen which I think was intended for the use of staff rather than visitors, although nobody seemed to object when I took my seat. I’d been there for a while, drinking black coffee and getting through two and a half bars of Fruit and Nut, when someone stopped by my table and said hello.
I glanced up. It was the nurse who had been looking after Fiona that morning.
‘How is she now?’ she asked.
‘Well, they’re putting her on a ventilator at the moment,’ I said. ‘I assume that means things are fairly serious.’
Her response was nonco
mmittal. ‘She’ll be very well looked after.’
I nodded glumly, and she sat down in the chair opposite me.
‘How are you feeling, though?’
I hadn’t really thought about this. After a second or two I said, rather to my own surprise: ‘I’m not sure. Angry, if anything.’
‘Not with Dr Bishop, I hope.’
‘No, not with anyone specific. I’d say it was with fate, except that I don’t actually believe in fate. With the particular chain of circumstances, I suppose, which has brought –’ Suddenly it struck me that I hadn’t understood her remark. ‘Why should I be angry with Dr Bishop?’
‘Well, it probably would have been better if she’d been given the antibiotics last night,’ she said doubtfully. ‘She might at least have been more comfortable that way. Not that it ought to make that much difference, in the long run …’
‘Hang on,’ I said. ‘I thought she did have them last night. I mean, that’s what they told me was going to happen.’
I could see it dawning on her that she shouldn’t have told me. She must have assumed that I already knew.
‘Look,’ she said, ‘I ought to be getting back to the ward …’
I followed her into the corridor but she wouldn’t answer any more of my questions, and I gave up when I caught sight of Dr Gillam out in the car park, wrapped up against the winter cold in her gloves and trench coat. I hurried to the main entrance and ran after her, catching up just as she was fumbling in her pocket for the car keys.
‘Can I have a word with you?’ I said.
‘Of course.’
‘I don’t want to keep you, if you’ve finished for the day …’
‘Never mind that. Was there something you wanted to know?’
‘Yes, there was.’ I hesitated. There seemed to be no tactful way of approaching this. ‘Is it true that Dr Bishop forgot to give Fiona her antibiotics last night?’
She said: ‘Where did you hear that?’
I said: ‘Is that what you were so angry about this morning?’
She said: ‘It might be a good idea if we went for a drink.’
As it was a Bank Holiday and the middle of the afternoon, all the pubs were shut. We were in a gloomy backwater of South West London. The best we could manage, in the end, was a bleak and characterless little café, rendered all the more tacky by the fact that it had obviously been designed to fool unwary customers into thinking that it was part of a well-known fast food chain. It called itself ‘Nantucket Fried Chicken’.
‘I think I’ve got the coffee,’ said Dr Gillam, after sipping from her paper cup. We swapped drinks.
‘No, this could be the tea,’ I said, testing it doubtfully. But we didn’t swap again. There didn’t seem much point.
‘You went through quite an ordeal last night,’ she began, after a few moments’ thought. ‘To tell the truth, what you went through was unacceptable. But I’m afraid I can’t apologize, because it happens all the time, and it would have happened anywhere else.’
‘It wasn’t quite what I … would have expected,’ I said, not sure where any of this was leading.
‘This is my last month as a doctor,’ she now announced, abruptly.
I nodded, more confused than ever.
‘I’m going to have a baby.’
‘Congratulations.’
‘I don’t mean that I’m pregnant. I mean that I might as well have a baby now, while I’m trying to decide what to do next. The fact is that I can’t really put up with this job any more. It depresses me too much.’
‘Why become a doctor in the first place,’ I asked, ‘if illness depresses you?’
‘Illness is only one of the things we’re fighting against.’
‘What are the others?’
She considered. ‘ “Interference” would be the best word, I suppose.’ She brushed this line of argument aside angrily. ‘I’m sorry, I don’t want this to turn into a political lecture. We should be talking about Fiona.’
‘Or Dr Bishop,’ I said. Then asked: ‘Is it true?’
‘The point is,’ she said, leaning forward, ‘that it’s no use trying to find scapegoats. He’d been on call for twenty-six hours. And they found the bed as quickly as they could. I was horrified when I heard about it this morning, but I don’t know why. As I said, it happens all the time.’
I tried to take this in. ‘So … I mean, what kind of effect are we talking about here?’
‘It’s hard to say. I don’t think the pneumonia would necessarily have taken hold the way it did. Not if she’d been put on to a ward straight away, and given her antibiotics last night.’
‘Look, if you’re telling me that her life’ – I didn’t want to say this; just by saying it, there was a danger of making it real – ‘that her life has been put in danger through somebody’s negligence –’
‘I’m not talking about negligence. I’m talking about people trying to work under conditions which are becoming impossible.’
‘Somebody must create those conditions!’
‘The decision to close wards is taken by managers.’
‘Yes, but on what basis?’
She sighed. ‘These are not people who feel a personal involvement with the hospital. They’re brought in from outside on short-term contracts to balance the books. If they balance the books by the end of the financial year then they get their bonus. Simple.’
‘And whose bright idea was that?’
‘Who knows? Some cabinet minister, some civil servant, some academic guru sitting on a policy-making committee.’
A name immediately flashed through my mind: Henry.
I said: ‘But that’s the only consideration, is it – finance?’
‘Not always.’ Dr Gillam smiled bitterly. ‘Another ward was closed a few days ago. Do you know why?’
‘Go on, I’ll buy it.’
‘War casualties.’
‘But we’re not at war,’ I said, not even certain that I’d heard her properly.
‘Well, somebody obviously thinks we will be soon, unless Saddam pulls his finger out. And this is one of the hospitals which has been told to clear some room for our gallant lads out at the front.’
There was no option but to believe her, however incredible it might seem. But I hated the way we were now expected to take this war for granted: where had it come from, this breezy assumption of inevitability? In any case, it was supposed to be nothing to do with me – something that was happening thousands of miles away, on the other side of the world: on the other side (which was further still) of a television screen. So how could I suddenly accept that it was now one of the forces conspiring against Fiona – that it had already crept into her blameless life? It was as if cracks had started to appear in the screen and this awful reality was leaking out: or as if the glass barrier itself had magically turned to liquid and without knowing it I had slipped across the divide, like a dreaming Orpheus.
All my life I’d been trying to find my way to the other side of the screen: ever since my visit to the cinema in Weston-super-Mare. Did this mean that I’d made it at last?
∗
Dr Gillam warned me about the ventilator. She told me not to be alarmed by what I saw. A chatty and efficient nurse led me on to the ward and, as before, I was struck by the contrast with the rest of the hospital. Everything here seemed quiet, modern and clinical. There were expensive-looking machines next to every bed. Lights flashed and pulsed, and I was subliminally conscious of a discreet electric hum which had a strangely calming effect. I walked straight past the other beds, not glancing to either side. I felt that to look at any of the other patients would be invasive.
Was the woman I saw that evening really Fiona? She bore no relation to the woman who had come with me to Eastbourne seven days earlier, or even to the woman who had sat up in bed and smiled at the prospect of our formal dinner for two on New Year’s Eve. She looked like a victim on a sacrificial altar. She looked like she was being attacked by snakes.
There was:
a tube for oxygen coming out of her mouth, its corrugated pipes forming a T-junction
a tube attached to a vein in her neck
a tube thrust into an artery in her wrist
a tube coming out of her bladder
a temperature probe on her finger
a drip for liquids
a drip for antibiotics
a mass of wires and tubing and pumps and brackets and supports and tape and cords, all connected up to a box-like machine which was covered with knobs and dials.
Fiona herself had been heavily sedated, and paralysed. Her eyes were open but she was barely conscious.
I asked her if she could hear me. There was a tiny movement behind her eyes, unless I was imagining it.
I said: ‘You don’t need to worry about a thing, Fiona. Dr Gillam’s been explaining everything, and I understand it all now. It turns out that I was right all along. I was right, and you were wrong. I don’t believe in accidents any more. There’s an explanation for everything: and there’s always someone to blame. I’ve found out why you’re here, you see. You’re here because of Henry Winshaw. Ironic, isn’t it? He wants you to be here because he can’t bear to think that his money or the money of people like him might be used to stop things like this from happening. It’s obvious, really. Not very difficult, as whodunnits go. An open and shut case. All we need now is to get hold of the murderer and bring him to justice. And bring in the rest of the family, while we’re at it. They’ve all got blood on their hands. It’s written all over their faces. There’s no end to the people who’ve died because of Mark and his obscene trade. Dorothy was the one who killed off my father, feeding him all that junk; and Thomas added a twist of the knife, making his money vanish into thin air just when he needed it. Roddy and Hilary have certainly done their bit. If imagination’s the lifeblood of the people and thought is our oxygen, then his job’s to cut off our circulation and hers is to make sure that we all stay dead from the neck up. And so they sit at home getting fat on the proceeds and here we all are. Our businesses failing, our jobs disappearing, our countryside choking, our hospitals crumbling, our homes being repossessed, our bodies being poisoned, our minds shutting down, the whole bloody spirit of the country crushed and fighting for breath. I hate the Winshaws, Fiona. Just look what they’ve done to us. Look what they’ve done to you.’