I hope you won’t mind if I include this next piece on the blog. Although it’s not about my life on the ambulance, it is about my life, so maybe it’ll fill in some of the blanks.
I’ve always tried in Siren Voices to keep myself in the background, to keep overt opinion out of the writing. There’s still plenty of bias, of course. I try to be even-handed, but it’s inevitable I’ll distort the truth of a situation by going after a particular feeling or effect.
I want to carry on doing that, but I thought now and again it might be interesting (and a bit of a change) to write some pieces with a more personal and personally revealing edge.
So here’s a piece I’ve written about the events surrounding my Dad’s death a few years ago. I have to say now – maybe more for my family than anyone else – that as personal recollection goes it’s as flawed as you’d expect. We all remember things differently, timings get changed around, and it’d be impossible to remember exactly what was said. The best I can do is honestly put down what seems to be the truest for me, my memory and my feelings about what happened.
I’d also like to include this piece as a respectful acknowledgement of the traumas and troubles of all those patients I’ve written about up till now. If I can write openly and honestly about their problems, I should expect to be able to do the same for my own.
Sometimes, an event happens in the life of a family of such consequence that like a syringe of dye dumped in a vein, the tangled network so long hidden is suddenly – dangerously - inked out for inspection, a thready network of kinks and loops, baggy thoroughfares, atrophied ends, tentative connections and recanalisations.
When what was hidden is laid open.
And then I suppose the challenge is not just how to read it all, but how to live with the consequences once you think you understand what is written there.
Dad had been suffering recurrent bouts of jaundice that left his face a screen print experiment in yellow. Even the rims of his eyes were golden. When the attacks came he would drag himself up the stairs to lie on his side in a darkened room, glittering beneath the covers, staring at the curtains, or throwing up in a bowl. The doctor was sent for, and a long road entered onto of hospital stays and investigations that led finally to an appointment with a Consultant Gastroenterologist and a biro sketch on the back of an envelope.
‘This is your stomach,’ the Consultant said, sitting on the edge of the hospital bed, smoothing the envelope out on his knee. He stretched his right arm out to ride his jacket sleeve up his arm, giving himself room to move, but looking like a magician proving he has nothing hidden there. Shirt cuffs a brilliant starched white.
Outside, through the sealed window of the eighth floor room, the sun lay across a patchwork of rape and wheat.
‘This is your duodenum, your bile duct, your pancreas, the rest of your small intestine here …’ He roughed out the pattern, his estimate for a difficult job.
‘Now, what we have in your case – what we’ve found – are a group of shadows here, here and here,’ scrawling a bunch of malign-looking dots. ‘They may be cancerous – the type of cancer that spreads, the bad sort – or they may be of a more benign pathogenesis. If they are the friendly sort, then they will only cause these intermittent bouts of jaundice and nothing much else. And there may be things we can do to make those bouts more tolerable. But if they are the cancerous sort, we would need to tackle them more positively.’
Dad cleared his throat.
‘So I’ve got cancer?’
‘Well – that may be. Our feeling is that you might well have cancer here. But we don’t know this for sure. We can only deal in percentage chances.’
‘What are the percentages?’
‘I would say maybe forty percent. That the shadows are cancerous.’
‘So there’s a sixty percent chance that if I do nothing, nothing will happen.’
‘But if they are cancerous?’
‘There’s a forty percent chance that if you did nothing your condition would deteriorate and you would die in six months or so. Cancers in this area tend to be quite aggressive in that respect.’
A sketch on an envelope. A spread bet on some dots.
Dad only ever bet on the football pools. A friend of his at work would drop by to collect the coupons and the money for the week. On Saturday at tea time he’d sit with his salmon and cress sandwiches on his lap, ticking off the results as they came rattling across the bottom of the TV screen. Methodically highlighting the score-draws, chewing over the results, looking for those vital games, the points that would change our lives, the golden points that would mean claims by telegram please, a huge cardboard cheque and a kiss on the cheek from some swim suited bird in a room filled with flashes and smiles and champagne showers, visions of big windows and bigger gardens, of space and light and freedom, an end to the eternal torment of the cycle ride to the office, an end to the double bed in the living room and territorial squabbles upstairs. But despite every new method he came up with – numbered sticks dropped in a heap, birthdays and high days, letting the children choose – the only telegram ever recorded in the family was from an aunt who couldn’t make the wedding.
It took a few days for Dad to reach a decision.
‘What would you do?’ he asked me, when the Consultant had left the room, and he sat there by the window, turning the envelope over and over in his hands.
‘It’s difficult. I don’t know. I think I probably would go ahead and have the operation.’
The Consultant had said that the chances of a full recovery from the operation were good. He’d done one the other week, the man would be going home soon. It sounded tough, though. There were risks.
‘So you think I should have the operation?’
‘He said chemo and radiotherapy wouldn’t work.’
‘So you’d have it?’
‘I’d want to do something.’
I was out of my depth. I didn’t understand the nature of the operation, other than it called for some radical re-plumbing, bits taken away, bits joined up in new and surprising ways.
Mum knew and I knew that my eldest brother Rich should have been sitting here. Rich, a GP, the one person in the family most qualified to be perched on a hospital bed trading percentage risks with a Consultant, translating envelope sketches into a family language of symbols we could better understand.
Of course, if what was really needed at that time was someone to come roaring up to the hospital on a motorbike, dump kit in the corner of the room, make stupid cracks, a cup of tea and whatever else it took, I was your very man. But these medical scripts? I was flailing around with my usual flair for the inappropriate, trying to imagine what I would do if I found myself with cancer of the bile duct, sitting there by the window, in that gown.
But what Rich thought or didn’t think was no longer available to us. When he left for medical school, no-one in the family realised, not my parents, not my four sisters, not my other brother, Craig (although he maintained later that it wasn’t a surprise to him, that the evidence had been there from the start), no-one realised that something more had happened than simply the freeing-up of a bed in the boys’ bedroom. Within a few years Rich had devolved almost completely from the family; after qualifying and moving up country, he was further away still, as inconspicuous as a satellite signalling from on an orbit at the coldest, furthest edge of things. He was absent from all family events and traumas. By the time of his second marriage, we saw nothing more of him. He had sloughed us all off like a skin.
What Dad made of it no-one could tell. He treated Rich’s absence with the same stoically dyspeptic face he turned to everything else, the same face he pulled when sometimes he would bite an apple and say: ‘This tastes like turnips’.
He had always thought Rich the least complicated, most effective, least troubled of all his children.
But then I learned that Rich had phoned home to find out what was happening, and had called the Consultant to discuss the case. None of us ever knew what he thought of the operation. Impressions of conversations with him only ever filtered back through Mum or Craig. But whatever he thought, the result stood nonetheless. Dad decided to go ahead.
Within a day or so he was in theatres, to ITU for recovery, then to a ward, then back to ITU with an infection, where he died the day after. All told, about a week.
How a life seemingly so settled and secure can suddenly fragment, burst apart and scatter not just into pieces, but into items of furniture, objects in a box, a scrap of paper covered with numbers or half a drawer of junk. How quickly we become the things we hardly thought of when we were alive. How quickly we move out of reach.
Like this overexposed photo of a Honda C90, the blue and white plastic scooter he’d ride up to the river to fish, or the shops on a Saturday morning to get the paper, or – astonishingly – two hundred and fifty miles to Exmouth, to stay with his elder sister Mae and her husband Frank. On the morning before each trip he would stand at the window, studying the sky.
‘I’ll leave it for a bit. Looks like rain.’
Or this metal detector, safely lain away like a shotgun at the back of a wardrobe.
Once I stood by with a trowel as he swept the disc back and forth across the clods of earth. There was a signal. I prodded around whilst he stood back, sniffing and watching.
‘It’s a washer.’
‘That’s not a washer. Pass it up here.’ Pressing off the dirt with the fatly gloved hands I grew into. ‘Yep. Thought so. That’s a dufer.’
‘Take it to Brown’s. Slap it on the counter. Say “That’ll dufer a packet of fags.’
A neat stack of back issues of The Lady.
Dad was going to put in an advert, Situations Wanted: Hard working handyman / gardener seeks live-in position. Anything considered. He had worked in the estimates department of the local printers for thirty years. A strong man, practical and funny, somehow finding himself at the back end of thirty years staring out of an office window, making plans.
Thirty years too long at the printers. Quite an over-run. But too old and too tied up at the end to do much about it. I remember once he came home from work early, slamming upstairs, the only time I ever heard him cry – a series of awful, raging chokes from behind the door. But a week later he went back there. He knew, everyone knew, he would have to go back. Make his apologies to the manager, keep his job. What else could he do?
The Lady: England’s First & Finest Weekly.
But then blessed retirement was upon him, absolving him of the need for these petty negotiations, drawing him down into the softer, more padded territories of the slow afternoon bonfire, the strategic nap, the biro circles in the paper marking out the evening’s TV.
And now he lay with his eyes taped shut and a corrugated tube coming out of his mouth, the kind of pipe you might hang out of a washing machine. The intricate ITU mechanisms fussed and buzzed around him as we took it in turns to stand guard. He was sealed up along the centre of his abdomen by a brutal scar whose crimped ridge rode up like the edge of a pasty. When I saw the wound I imagined a surgeon up to his elbows in gore, periodically looking up to consult an envelope being held out by a nurse, riffling on impatiently until finally he straightened up, snapped the guts shut like a Gladstone bag and clipped smartly away down the corridor.
We lived for a couple of days in the relatives’ room. Slept on the chairs there. Made coffee in the kitchenette next door. Paced the room, took turns by his bed, read celebrity magazines, stared at them with paper eyes by the hard overhead strips and the blue light easing in through the window. It had been many years since we had slept under the same roof. But there were no revelations, no late night confessions.
‘These seats are so hard.’
‘What’s the time?’
‘I’m just going to the shop. Do you want anything?’
An assorted box of family members, like the pieces to an old game you come across unexpectedly and study closely, with a dislocated sense of time having moved on, and something significant left unchanged.
I know my answer to the question: What would you do if the world was going to end in five minutes?
‘I’m just going to the shop. Do you want anything?’
Dad carried on breathing for ten minutes or more when the machines were finally turned off. Stoking little gasps, without depth or hope, without end. My sisters, their families, a niece and nephew, Craig and me were all gathered around, touching his hands, forehead –a lacklustre crowd trying levitation by touch. Mum had her face pressed against his hand where it lay palm down by his side.
‘He’s still breathing. Can’t we do something?’
‘There’s nothing to be done. It’s a reflex action.’
‘But he’s still breathing. We must be able to do something.’
‘He’s a fighter. He won’t let go.’
‘Let go, Dad. Just let go.’
‘It’ll pass soon,’ said the nurse. ‘These are his last breaths now.’
‘But can’t we do something?’
Rich eventually phoned Mum to find out the time of the funeral. I guessed who it was through the hall door. I came through and asked if I could speak to him briefly. Reluctantly she handed me the phone.
‘Where were you?’
‘He was dying. He asked for you. He wanted to see you one last time. He was fucking dying, and you couldn’t even make that.’
‘You’re just mad because you told him to have the operation and he died.’
‘You’re a heartless bastard.’
A laugh. ‘And you? You’re mentally disturbed. You need help.’
‘I want nothing more to do with you.’
‘See a doctor, mate.’
I handed Mum back the phone.
‘Don’t,’ she said. ‘Don’t.’
A pause in the run of events. The coffin had been lowered into the grave, and time given over for the throwing in of a handful of earth, a bunch of flowers, a last glance before the ground was closed up again.
I had brought my camera but I’m pretty slack. The whole day I had only taken a few pictures of the garden back home coming into flower, and children chasing each other around the gravestones in the cemetery. I thought I needed something more substantial, so I went up to the edge to take a photo of the coffin in the grave, feeling self-conscious, wondering how it would look in an album but not wanting to miss the moment. I looked down and tried to imagine Dad lying there, the expression on his face close up against that lid, just about where the metal plate was screwed, reflecting the sun so I couldn’t see what was written on it. As I focused the lens I remembered a photo of Dad looking up from his deckchair in the garden, his favourite orange t-shirt riding up over his belly. The quizzical anger on his face, that frown, as he unlaced his hands from behind his head, as if he were going to get up, as if he were going to do something.
But I’m no photographer. When I got the pictures back, the three or four I took of the coffin all had my shadow lying across it.