The Complete Short Stories, Volume 2

by J. G. Ballard

  Later, when the pain from his amputated leg roused him from this placid second sleep, Nurse Sadie at last began to look at his face. She told him that his aunt had come to visit him each day after the accident, and that she would return the following afternoon.

  ‘… Theodore – Uncle Theodore … ?’ Conrad tried to sit up but an invisible leg, as dead and heavy as a mastodon’s, anchored him to the bed. ‘Mr Foster … my uncle. Did the car … ?’

  ‘Missed him by yards, dear. Or let’s say inches.’ Nurse Sadie touched his forehead with a hand like a cool bird. ‘Only a scratch on his wrist where the windshield cut it. My, the glass we took out of you, though, you looked as if you’d jumped through a greenhouse!’

  Conrad moved his head away from her fingers. He searched the rows of empty beds in the ward. ‘Where is he? Here … ?’

  ‘At home. Your aunt’s looking after him, he’ll be right as rain.’

  Conrad lay back, waiting for Nurse Sadie to go away so that he could be alone with the pain in his vanished leg. Above him the surgical cradle loomed like a white mountain. Strangely, the news that Uncle Theodore had escaped almost unscathed from the accident left Conrad without any sense of relief. Since the age of five, when the deaths of his parents in an air disaster had left him an orphan, his relationship with his aunt and uncle had been, if anything, even closer than that he would have had with his mother and father, their affection and loyalties more conscious and constant. Yet he found himself thinking not of his uncle, nor of himself, but of the approaching car. With its sharp fins and trim it had swerved towards them like the gulls swooping on the turtles, moving with the same rush of violence. Lying in the bed with the cradle over him Conrad remembered the turtles labouring across the wet sand under their heavy carapaces, and the old men waiting for them among the dunes.

  Outside, the fountains played among the gardens of the empty hospital, and the elderly nurses walked in pairs to and fro along the shaded pathways.

  The next day, before his aunt’s visit, two doctors came to see Conrad. The older of the two, Dr Nathan, was a slim grey-haired man with hands as gentle as Nurse Sadie’s. Conrad had seen him before, and remembered him from the first confused hours of his admission to the hospital. A faint half-smile always hung about Dr Nathan’s mouth, like the ghost of some forgotten pleasantry.

  The other physician, Dr Knight, was considerably younger, and by comparison seemed almost the same age as Conrad. His strong, square-jawed face looked down at Conrad with a kind of jocular hostility. He reached for Conrad’s wrist as if about to jerk the youth from his bed on to the floor.

  ‘So this is young Foster?’ He peered into Conrad’s eyes. ‘Well, Conrad, I won’t ask how you’re feeling.’

  ‘No …’ Conrad nodded uncertainly.

  ‘No, what?’ Dr Knight smiled at Nathan, who was hovering at the foot of the bed like an aged flamingo in a dried-up pool. ‘I thought Dr Nathan was looking after you very well.’ When Conrad murmured something, shy of inviting another retort, Dr Knight sped on: ‘Isn’t he? Still, I’m more interested in your future, Conrad. This is where I take over from Dr Nathan, so from now on you can blame me for everything that goes wrong.’

  He pulled up a metal chair and straddled it, flicking out the tails of his white coat with a flourish. ‘Not that anything will. Well?’

  Conrad listened to Dr Nathan’s feet tapping the polished floor. He cleared his throat. ‘Where is everyone else?’

  ‘You’ve noticed?’ Dr Knight glanced across at his colleague. ‘Still, you could hardly fail to.’ He stared through the window at the empty grounds of the hospital. ‘It’s true, there is hardly anyone here.’

  ‘A compliment to us, Conrad, don’t you think?’ Dr Nathan approached the bed again. The smile that hovered around his lips seemed to belong to another face.

  ‘Yeesss …’ Dr Knight drawled. ‘Of course, no one will have explained to you, Conrad, but this isn’t a hospital in quite the usual sense.’

  ‘What –?’ Conrad began to sit up, dragging at the cradle over his leg. ‘What do you mean?’

  Dr Knight raised his hands. ‘Don’t misinterpret me, Conrad. Of course this is a hospital, an advanced surgical unit, in fact, but it’s also something more than a hospital, as I intend to explain.’

  Conrad watched Dr Nathan. The older physician was gazing out of the window, apparently at the fountains, but for once his face was blank, the smile absent.

  ‘In what way?’ Conrad asked guardedly. ‘Is it something to do with me?’

  Dr Knight spread his hands in an ambiguous gesture. ‘In a sense, yes. But we’ll talk about this tomorrow. We’ve taxed you enough for the present.’

  He stood up, his eyes still examining Conrad, and placed his hands on the cradle. ‘We’ve a lot of work to do on this leg, Conrad. In the end, when we’ve finished, you’ll be pleasantly surprised at what we can achieve here. In return, perhaps you can help us – we hope so, don’t we, Dr Nathan?’

  Dr Nathan’s smile, like a returning wraith, hovered once again about his thin lips. ‘I’m sure Conrad will be only too keen.’

  As they reached the door Conrad called them back.

  ‘What is it, Conrad?’ Dr Knight waited by the next bed.

  ‘The driver – the man in the car. What happened to him? Is he here?’

  ‘As a matter of fact he is, but …’ Dr Knight hesitated, then seemed to change course. ‘To be honest, Conrad, you won’t be able to see him. I know the accident was almost certainly his fault –’

  ‘No!’ Conrad shook his head. ‘I don’t want to blame him … we stepped out behind the truck. Is he here?’

  ‘The car hit the steel pylon on the traffic island, then went on through the sea wall. The driver was killed on the beach. He wasn’t much older than you, Conrad, in a way he may have been trying to save you and your uncle.’

  Conrad nodded, remembering the white face like a scream behind the windshield.

  Dr Knight turned towards the door. Almost sotto voce he added: ‘And you’ll see, Conrad, he can still help you.’

  At three o’clock that afternoon Conrad’s uncle appeared. Seated in a wheelchair, and pushed by his wife and Nurse Sadie, he waved cheerily to Conrad with his free hand as he entered the ward. For once, however, the sight of Uncle Theodore failed to raise Conrad’s spirits. He had been looking forward to the visit, but his uncle had aged ten years since the accident and the sight of these three elderly people, one of them partially crippled, coming towards him with their smiling faces only reminded him of his isolation in the hospital.

  As he listened to his uncle, Conrad realized that this isolation was merely a more extreme version of his own position, and that of all young people, outside the walls of the hospital. As a child Conrad had known few friends of his own age, for the single reason that children were almost as rare as centenarians had been a hundred years earlier. He had been born into a middle-aged world, one moreover where middle age itself was for ever moving, like the horizons of a receding universe, farther and farther from its original starting point. His aunt and uncle, both of them nearly sixty, represented the median line. Beyond them was the immense super-annuated army of the elderly, filling the shops and streets of the seaside town, their slow rhythms and hesitant walk overlaying everything like a grey veil.

  By contrast, Dr Knight’s self-confidence and casual air, however brusque and aggressive, quickened Conrad’s pulse.

  Towards the end of the visit, when his aunt had strolled to the end of the ward with Nurse Sadie to view the fountains, Conrad said to his uncle, ‘Dr Knight told me he could do something for my leg.’

  ‘I’m sure he can, Conrad.’ Uncle Theodore smiled encouragingly, but his eyes watched Conrad without moving. ‘These surgeons are clever men; it’s amazing what they can do.’

  ‘And your hand, Uncle?’ Conrad pointed to the dressing that covered his uncle’s left forearm. The hint of irony in his uncle’s voice reminded him of Dr Knight’s studied amb
iguities. Already he sensed that people were taking sides around him.

  ‘This hand?’ His uncle shrugged. ‘It’s done me for nearly sixty years, a missing finger won’t stop me filling my pipe.’ Before Conrad could speak he went on: ‘But that leg of yours is a different matter, you’ll have to decide for yourself what to have done with it.’

  Just before he left he whispered to Conrad, ‘Rest yourself well, lad. You may have to run before you can walk.’

  Two days later, promptly at nine o’clock, Dr Knight came to see Conrad. Brisk as ever, he came to the point immediately.

  ‘Now, Conrad,’ he began, replacing the cradle after his inspection, ‘it’s a month since your last stroll by the beach, time to get you out of here and back on your own feet again. What do you say?’

  ‘Feet?’ Conrad repeated. He managed a slight laugh. ‘Do you mean that as a figure of speech?’

  ‘No, I mean it literally.’ Dr Knight drew up a chair. ‘Tell me, Conrad, have you ever heard of restorative surgery? It may have been mentioned at school.’

  ‘In biology – transplanting kidneys and that sort of thing. Older people have it done. Is that what you’re going to do to my leg?’

  ‘Whoa! Hold your horses. Let’s get a few things straight first. As you say, restorative surgery goes back about fifty years, when the first kidney grafts were made, though for years before that corneal grafting was commonplace. If you accept that blood is a tissue the principle is even older – you had a massive blood transfusion after the accident, and later when Dr Nathan amputated the crushed knee and shinbone. Nothing surprising about that, is there?’

  Conrad waited before answering. For once Dr Knight’s tone had become defensive, as if he were already, by some sort of extrapolation, asking the questions to which he feared Conrad might subsequently object.

  ‘No,’ Conrad replied. ‘Nothing at all.’

  ‘Obviously, why should there be? Though it’s worth bearing in mind that many people have refused to accept blood transfusions, even though it meant certain death. Apart from their religious objections, many of them felt that the foreign blood polluted their own bodies.’ Dr Knight leaned back, scowling to himself. ‘One can see their point of view, but remember that our bodies are almost completely composed of alien materials. We don’t stop eating, do we, just to preserve our own absolute identity?’ Dr Knight laughed here. ‘That would be egotism run riot. Don’t you agree?’

  When Dr Knight glanced at him, as if waiting for an answer, Conrad said, ‘More or less.’

  ‘Good. And, of course, in the past most people have taken your point of view. The substitution of a healthy kidney for a diseased one doesn’t in any way diminish your own integrity, particularly if your life is saved. What counts is your own continuing identity. By their very structure the individual parts of the body serve a larger physiological whole, and the human consciousness is great enough to provide any sense of unity.

  ‘Now, no one ever seriously disputed this, and fifty years ago a number of brave men and women, many of them physicians, voluntarily gave their healthy organs to others who needed them. Sadly, all these efforts failed after a few weeks as a result of the so-called immunity reaction. The host body, even though it was dying, still fought against the graft as it would against any alien organism.’

  Conrad shook his head. ‘I thought they’d solved this immunity problem.’

  ‘In time, yes – it was a question of biochemistry rather than any fault in the surgical techniques used. Eventually the way became clear, and every year tens of thousands of lives were saved – people with degenerative diseases of the liver, kidneys, alimentary tract, even portions of the heart and nervous system, were given transplanted organs. The main problem was where to obtain them – you may be willing to donate a kidney, but you can’t give away your liver or the mitral valve in your heart. Luckily a great number of people willed their organs posthumously – in fact, it’s now a condition of admission to a public hospital that in the event of death any parts of one’s body may be used in restorative surgery. Originally the only organs that were banked were those of the thorax and abdomen, but today we have reserves of literally every tissue in the human body, so that whatever the surgeon requires is available, whether it’s a complete lung or a few square centimetres of some specialized epithelium.’

  As Dr Knight sat back Conrad pointed at the ward around him. ‘This hospital … this is where it happens?’

  ‘Exactly, Conrad. This is one of the hundreds of institutes we have today devoted to restorative surgery. As you’ll understand, only a small percentage of the patients who come here are cases such as yours. The greatest application of restorative surgery has been for geriatric purposes, that is, for prolonging life in the aged.’

  Dr Knight nodded deliberately as Conrad sat up. ‘Now you’ll understand, Conrad, why there have always been so many elderly people in the world around you. The reason is simple – by means of restorative surgery we’ve been able to give people who would normally die in their sixties and seventies a second span of life. The average life span has risen from sixty-five half a century ago to something close to ninety-five.’

  ‘Doctor … the driver of the car. I don’t know his name. You said he could still help me.’

  ‘I meant what I said, Conrad. One of the problems of restorative surgery is that of supply. In the case of the elderly it’s straightforward, if anything there’s an excess of replacement materials over the demand. Apart from a few generalized degenerative conditions, most elderly people are faced with the failure of perhaps no more than one organ, and every fatality provides a reserve of tissues that will keep twenty others alive for as many years. However, in the case of the young, particularly in your age group, the demand exceeds supply a hundred-fold. Tell me, Conrad, quite apart from the driver of the car, how do you feel in principle about undergoing restorative surgery?’

  Conrad looked down at the bedclothes. Despite the cradle, the asymmetry of his limbs was too obvious to miss. ‘It’s hard to say. I suppose I …’

  ‘The choice is yours, Conrad. Either you wear a prosthetic limb – a metal support that will give you endless discomfort for the rest of your life, and prevent you from running and swimming, from all the normal movements of a young man – or else you have a leg of flesh and blood and bone.’

  Conrad hesitated. Everything Dr Knight had said tallied with all he had heard over the years about restorative surgery – the subject was not taboo, but seldom discussed, particularly in the presence of children. Yet he was sure that this elaborate résumé was the prologue to some far more difficult decision he would have to take. ‘When do you do this – tomorrow?’

  ‘Good God, no!’ Dr Knight laughed involuntarily, then let his voice roll on, dispelling the tension between them. ‘Not for about two months, it’s a tremendously complex piece of work. We’ve got to identify and tag all the nerve endings and tendons, then prepare an elaborate bone graft. For at least a month you’ll be wearing an artificial limb – believe me, by the end you’ll be looking forward to getting back on a real leg. Now, Conrad, can I assume that in general you’re quite willing? We need both your permission and your uncle’s.’

  ‘I think so. I’d like to talk to Uncle Theodore. Still, I know I haven’t really got any choice.’

  ‘Sensible man.’ Dr Knight held out his hand. As Conrad reached to take it he realized that Dr Knight was deliberately showing him a faint hairline scar that ran around the base of his thumb and then disappeared inside the palm. The thumb seemed wholly part of the hand, and yet detached from it.

  ‘That’s right,’ Dr Knight told him. ‘A small example of restorative surgery. Done while I was a student. I lost the top joint after infecting it in the dissecting room. The entire thumb was replaced. It’s served me well; I couldn’t really have taken up surgery without it.’ Dr Knight traced the faint scar across his palm for Conrad. ‘There are slight differences of course, the articulation for one thing – this one is
a little more dexterous than my own used to be, and the nail is a different shape, but otherwise it feels like me. There’s also a certain altruistic pleasure that one is keeping alive part of another human being.’

  ‘Dr Knight – the driver of the car. You want to give me his leg?’

  ‘That’s true, Conrad. I should have to tell you, anyway, the patient must agree to the donor – people are naturally hesitant about being grafted to part of a criminal or psychopath. As I explained, for someone of your age it’s not easy to find the appropriate donor …’

  ‘But, Doctor –’ For once Dr Knight’s reasoning bewildered Conrad. ‘There must be someone else. It’s not that I feel any grudge against him, but … There’s some other reason, isn’t there?’

  Dr Knight nodded after a pause. He walked away from the bed, and for a moment Conrad wondered if he was about to abandon the entire case. Then he turned on his heel and pointed through the window.

  ‘Conrad, while you’ve been here has it occurred to you to wonder why this hospital is empty?’

  Conrad gestured at the distant walls. ‘Perhaps it’s too large. How many patients can it take?’

  ‘Over two thousand. It is large, but fifteen years ago, before I came here, it was barely big enough to deal with the influx of patients. Most of them were geriatric cases – men and women in their seventies and eighties who were having one or more vital organs replaced. There were immense waiting lists, many of the patients were trying to pay hugely inflated fees – bribes, if you like – to get in.’

  ‘Where have they all gone?’

  ‘An interesting question – the answer in part explains why you’re here, Conrad, and why we’re taking a special interest in your case. You see, Conrad, about ten or twelve years ago hospital boards all over the country noticed that admission rates were starting to fall off. To begin with they were relieved, but the decline has gone on each year, until now the rate of admission is down to about one per cent of the previous intake. And most of these patients are surgeons and physicians, or members of the nursing staff.’