A Case of Knives (11 page)

My first hospital brought my first happy sex. In the white laundry, among slapping towels, tents of sheet, eight osier chariots full of dirty white linen, and the rolling surge of industrial washing machines, the slippery floor gritty with fragrant blue Daz and my eyes stung with bleach, I embraced and was embraced. I was old to be learning, and my joy was great. The smell of hospitals, which is fearful to many, is mysterious and delicious to me. The hospital was the first world beyond my family. It was disciplined and self-contained; the first institution discovered after the family is laid down for nostalgia, and the glamour and function of hospital are blended for me into something for which I feel what could almost be called patriotism. Their glamour offers me something resembling that which hotels offer the homeless rich.

As I grew into a real doctor, then specialised and became a consultant and at length a recognised plumber of the heart, so I became more dependent yet on my hospitals, though no longer dependent on them for love. I could not be. My success had stripped me of the anonymity which had made things easy before. I was not tempted either to try to find my first paradise again. Just as public school boys move on to their clubs, I moved on, without losing the tingle of danger and indulgence I had enjoyed. In Turkish baths, in plain tiled lavatories, I remember the sluices and laundries in which I had first been happy.

The hospital where I have been for some years now was built as a small foundling hospital. It has grown four times; once, when a philanthropist commissioned Norman Shaw to add to its modest single block. He added long windows set in a tall façade of stone; pendant from each window is a small false gallery, faced with tiles, in eggy blues, greens and sunlight yellow. There are twelve windows and each set of tiles depicts a different illness, succoured by men and women dressed in long green robes, much as we appear, in fact, though the intention is pre-Raphaelite. Conspicuously absent are heart-disease and cancer and the new Pink Death. Brain-fever and tuberculosis are there, and infant death. No cure for that, but the panel parallel shows a slim woman with a furled armful which may be a baby though it looks like a small adult, standing up as present and correct as the Bambino. At the upper corners of each of these glossy tablets is a tile showing a snake bandaging a meaty iris stem, the flower signifying the Trinity. This part of the Hospital is called the Trinity Wing, which makes me think of a wounded dove – a Holy Ghost – winged, as it flies over, by a bad shot. I enjoy Christian iconography; it is like roadsigns, an attempt to find a language which will show all nations the way, without taking into account that what is St  Mark to one man is a bored old lion to another.

The next two additions were made in the 1960s. They are buttressed with spindly steel and their surface is hubbled and the yellow of coarse sand. The buttresses are as awkward as the legs of drinking giraffes. None of the windows in this part of the hospital is without its niggling draught. Inside, the optimism of that decade has allowed the architects to waste a great deal of space. There is a wide hall with a gorilla-sized mother and child carved from granite. I have not seen less living rock. It feeds out its own cold, which it retains all year, intensifying in winter. The only thing about the sculpture which is on the human scale is held in the hand of the monstrous child. It is a ball, or a fruit. This part of the hospital is where the children are treated, and many of them touch this ball as they come and go, so it is sometimes warm. Single mittens are put there, until they are paired up, or lost again.

The remaining addition to the hospital is ‘my’ part. It adjoins the original building and is devoted to disorders of the heart. It is not large but it is efficient, containing two theatres. Because it is not large, there are not so many corridors, which patients fear. Seen from outside, the building is an upright creamy tube, with a sloped roof, whose window is a single ox-eye. The body of the building is pierced with what look like arrowslits. Artificial light is a constant requirement. We have two generators. The theatre in which I most frequently operate is in the top room. Because of the height and angle of the window, you cannot see out, but I have looked up to see stars from there, and dawn breaking. Every part of this modern cylinder is in use. Insofar as this is possible, there are no corners to contain dirt; unlike most followed-through architectural theories, this does not seem to be foolish and is handsome. It is also appropriate, as the building and my department were endowed by a man whose fortune was made from the manufacture of cleaning agents ‘good at reaching corners’. Only once the patients are mending in health does this cornerlessness present problems. The furniture of convalescence – sofas, chairs, the television – is incongruous in the circular rooms. Occasionally, I wonder whether I should ask Tertius to have one of his designer friends make appropriate, curvilinear, furniture, which I shall give to the hospital. Then I reflect that coin is both circular and more appropriate.

I took the lift up to the ward, having been to the consultants’ room in the main block. I was greeted by many nurses, each busy with something, as though in a diorama of a well-working hospital. I sometimes feel like a performer, with great longueurs between performances, while my juniors ensure that what is real – tests, readings, turning, dredging, wiping, feeding – all go on. They fill time. It is only once the patients are asleep, and the nurses begin to knit and quietly talk about husbands and children, that the truth comes out again. Life is dense with empty space.

The little brown boy was asleep. When I see the very small children with tubes in their noses and arms and sides, they look like puppets on transparent proteinous strings. To mediums, that is what we are. Geneticists know this too, I suppose, as we dance about on our helical threads. The boy was about two, but in that prim bliss of baby sleep he looked younger. His mother appeared to be praying. In fact she was helping a grumpy old man, who had come in from the adults’ ward, with a crossword clue. It was one of those crosswords which are called ‘quick’. The old man was in a dressing-gown with a badge over the breast. The crest was not familiar; it must be that of a chain store. I imagined he had six months left to him of life. He had a vile temper and did not enjoy the visits of his wife. One of the nurses had heard him crying at night. He had told her he did not want to die, he loved life. Each day, he made the newspaper last. He would call the more gullible nurses over on a pretext and then say, ‘Dreadful, isn’t it, shouldn’t be allowed, crying shame,’ and show them the photograph of the naked girl in the paper to make them blush. Then he would scuttle off to the bathroom to shave. He disliked many things, which gave him a sort of firewatcher’s vigilance. That he was currently doing the quick crossword with one of the things he most disliked he had not noticed. He fawned on me, with a menacing servility.

‘The opposite of white, Doc, even I can do that one, that’s another one done. I do not mind telling you this lady is not bad at this at all, are you, love?’

‘Another question right away please, Mr  Mallard,’ she said, handing him a squashed paper bag of fried plantain discs. She seemed incurious about the child. I think she felt that as long as she was there, he would be safe. Perhaps she had once momentarily left the bedsides of her other sons, and saw their deaths explained in that.

‘All’s well that ends blank,’ said Mr  Mallard.

‘Well,’ said the mother, and I wondered what her house looked like inside and if she let her girls play outside in the street.

‘Eh?’ said Mr Mallard. ‘Too deep for me that one. Not at all bad these sweets. Taste of banana.’ Then, perhaps feeling he had been too nice, a bit womanish, he continued. ‘Bastards, the lot of them. It all began with that star in the East, of course, if we hadn’t of had that we wouldn’t of had years and decades of rule by rag heads, front wheelers, left footers, and how’s your father.’ But for the possession of his pension and his precious ill health, Mr  Mallard would have been one of those fierce invertebrate drinkers with red eyes who free associate at bus stops and have scabs on their faces and wet trousers. As it was, he was ill enough to live in hospital, like a rearrested criminal.

‘Sit down and get comfy, Mr  Mallard,’ said the mother of the sleeping child. She searched in the bag at her side and brought out a tissue and a Jaffa Cake. The tissue was mauve.

‘Your nose needs a good blow,’ she said, ‘and then you can have a biscuit. You like these don’t you?’ She was speaking to the old man.

It is a mother’s wish, I observed, in my own mother and in all the mothers who come to guard their children in the hospital, to feed her child. While her sleeping boy was having glucose dripped into his vein, this woman was feeding Mr  Mallard. The baby had eyebrows which met, like a man’s. About the room were people making the best they could of the conditioned air, false lights and dim colours of the hospital. By now it was legitimate visiting time and the tippling of barley water and handing over of gifts from home had begun. It was the nurses’ job to send Mallard out of the children’s ward. They had allowed the mother in her synthetic silks to stay because of ‘the history’, as it is called. She was also a great keener, and this is very bad in hospitals. When they sense hysteria the patients get insubordinate and plot against the staff whom they suddenly see as enemies. We have a room where parents may sleep. On its wall is a crucifix, in tooth-coloured plastic. Christ has a foppish smile and His feet are crossed as though spatted. The hole in His side looks like a buttonhole.

‘Prithee, undo this button,’ I thought. There are those thoughts which are a refrain, which you do not intend to think, yet which you think daily. They are automatic and not especially illuminating. I think of these words when I operate and am close to the distinction between living and not living, just a breath. I also think it just before the act with my boys. But when it seems most pathetic to me is when I am operating on a child. Silly word as button is, it is the right one. It stands for life, and the child’s death leaves a hole you cannot mend. You may stitch it up, but it will always be clear that something has been there, and is now gone, something round and essential for security.

I spent the early part of the afternoon making sure that the theatre and the nurses I required were prepared for that afternoon’s operation. We began at three o’clock and stopped at eight. I like to keep an atmosphere with none of that tension which is shown in hospital-television. I like a sober neutrality; there is a beefiness in my colleagues, especially obstetricians, which is not suitable. Today’s patient was a girl of about Cora’s age. About her wrist was a plastic bangle, which said,
steel
, Dolores. She had been born with a heart murmur. It had recently worsened. If you have, as I do, an italic hand, you will write in that word murmur exactly what the electrocardiograph does not show when it is registering a murmuring heart. Instead of the regular up and down of the beat, mur, mur, there are pauses.

When we had finished with Dolores Steel, my last shift male nurse said to me before he left for home, ‘A real heartstopper, that bird.’ There are those who do not think as we do.

He noticed nothing strange in his own word. When I was clean, I took the lift down to the hall, said goodnight to the porter who was reading a paperback bent back on itself, and got into the safe interior of my car. It was a rainy night. I closed the door, heavy and snug, and turned on my lights. Only as I turned out of the gates, and the first sweep of the windscreen wipers began, did I see the letters written across my windscreen in red grease. The writer had taken care that I should be able to read the letters in sequence from inside the car.

‘
we know
,’ they said.

Petrol is a solvent for grease, so I used a little from my emergency can and spoilt my handkerchief. It was the first time my handkerchief had been covered with lipstick.

Chapter 10

The next days were busy for me. Because I had the central worry of Hal, with its new matrimonial turn, and then the natural and necessary worry of my work, I did not wonder very often who ‘knew’, or what. I was surprised, like most owners of sumptuous cars, that the attack had not been more permanent and damaging.

I had spoken during the week only once to Hal, when he rang me, as he had promised, to find Cora’s telephone number. He telephoned just as I was beginning my late supper after operating on the murmuring heart of Dolores Steel. He was calling from somewhere where there was a dull and regular beat, with occasional rattlings. It sounded as though he was not far from a battle at sea, the distantness of the telephone and yet its closeness to my ear giving the absent yet carried quality sound has over water. I gave Cora’s number to him and asked him how he was.

‘Better than for a long time. I think I could be seeing my way to sorting things out.’

I do not believe he thought of speaking to me in the way I thought of speaking to him.

‘Goodnight, Hal, stay well,’ I said, meaning it as a father will mean ‘Take care’ to his child.

‘And you,’ he said, taking it as an impersonal injunction he might as well have been giving to a man who had sold him a razor.

I ate my boiled egg with pumpernickel and capers. I like the scourging taste of things kept in vinegar. In my refrigerator are jars with vegetables held like specimens in the clear liquid, cucumbers and cauliflowers like seaslugs and heads of coral, and hydras of dill suspended above. I keep small pearly corn cobs and lotus roots which show an Islamic flower when you slice them, and a jar of beetroots, as small as I can find. Concepçión must give these to her boy, I think, because his cream-yellow hand is sometimes stained pink if I come home early. Children like vinegar; a physiologist of the tongue may say that the distinction between sweet and sour is the last to come. Does that make me a child?