Fractured (6 page)

Wednesday, 5 August 2009

Anna watched the grey light from outside begin to creep into the hospital room, softly edging its way through the gaps in
the blinds. It draped itself over the bed; she rolled away from it so it couldn’t reach her. She was sure she had only fallen
asleep a few minutes earlier. She blinked, yawned, then reached for the glass of water on the bedside table.

Tony sprang up. ‘Is everything OK?’

She looked at him and smiled. ‘Yes, I’m fine, babe.’

He yawned, then rubbed at the dark stubble on his face. ‘How do you feel?’

‘Tired. I don’t think I slept at all.’

‘Me neither,’ he said.

‘Yes, you did! You were snoring all night.’ She got up, and went to sit next to Tony. She leaned into him and ran her fingers
through his hair. He lifted his head onto her stomach, kissed it, then whispered to the baby that it was time to come out
now.

Closing her eyes, she savoured the peacefulness of that moment, knowing it would be the last time they would be a couple.
Soon, they would be a family.

* * *

She screwed her eyes closed and pursed her lips, panting, as the force of a contraction powered through her body.

‘Just do your breathing, babe,’ Tony said, holding her hand. ‘Remember, they said in the classes not to hyperventilate, you
need to slow down.’

‘Yes, I remember!’ She shook off his hand and moaned, looking up at the high window that let some daylight in to counter the
harsh white fluorescent light of the delivery room. The contraction started to ease.

‘Is it going away?’

She nodded. Her mouth was so dry; she licked her lips. ‘Can you get me a drink from the bag?’

Tony stood up from the chair beside her and went to the black daypack at the end of the bed. The bag had sat inside the front
door of their house for weeks, decorated with bright pink sticky notes to remind her of last-minute items to add before they
left for the hospital. Tony rummaged in the bag and found the drink. He unscrewed it for her, and she took a sip.

‘Thanks.’ She turned to the midwife, who was sitting at a small workstation with her back to them, looking as though she was
so absorbed in her work that she couldn’t hear everything that was going on. ‘Debbie?’ she said. ‘Can we turn down the air
conditioning in here? I’m a bit cold.’

Debbie turned and smiled. She was in her fifties, with bleached-blonde hair tied back with a fluffy black hairband. She spun
the squeaking chair around with her toes, jumped down and walked over to the bed. She picked up the remote control for the
air conditioner and changed the temperature. ‘Do you want another blanket?’

‘No, thanks.’

‘OK. I’ll leave this remote here for you.’ She padded back to her desk.

Anna looked at her watch; was it really only 10 a.m.? So much had happened since they came down from the ward. None of it
was in her written birth plan, which she’d given to Debbie when they arrived. There was nothing in there about having needles
in the back of her hand and medications to start contractions. There
was nothing about having her membranes ruptured by something resembling a large crochet hook, or about the gush of hot liquid
that pulsed and poured from her straight afterwards. She hated that Tony had seen her like that.

Another contraction was building. She put the drink down and closed her eyes, bracing herself. As it strengthened, she swung
her legs over the end of the bed and bent forward, moaning. Tony rubbed her back; she swept his hand away. ‘Don’t!’

Tony stepped away. ‘Sorry.’

She wanted to apologise, but didn’t have the energy.

Debbie turned around again from her station at the desk. ‘The anaesthetist is in the ward – have you considered an epidural?’

Anna shook her head. It was in her birth plan that she didn’t want to be offered pain relief; if she wanted it, she’d ask
for it. Why had she bothered?

‘Why don’t you try it, babe?’ Tony said.

She glared at him. He knew how much she wanted to do this naturally. ‘I’m OK.’

‘No, you’re not,’ he said. ‘It’s hard to see you in such pain. You don’t need —’

‘I said I’m fine!’

Debbie came over and looked at the screen of the machine attached to the leads on Anna’s belly. ‘Well, it’s entirely your
decision. But it’s early days yet. I’m going to turn up the drip soon to get these contractions going a bit, and things might
get pretty intense quite quickly. Once the anaesthetist is in theatre, I can’t guarantee that he can come straight away when
you need him; it could take an hour or so …’

‘An hour?’ Anna looked over at Tony again. What if she couldn’t cope for an hour?

‘Just get it now, babe,’ he urged her. ‘You’re going to be tired enough, don’t make this harder than it needs to be.’

‘It’s your choice, Anna,’ Debbie said, turning back to her desk.

She looked from Debbie back to Tony. It was obvious that they both wanted her to accept defeat. It didn’t feel like she had
any choice at all.

She’d embraced every part of her pregnancy, good and bad. Even in the early weeks when she was tortured by nausea and pounding
headaches, when she retched and vomited every day, she never complained. It was all part of the experience that she had wanted
for so long; it was her body’s way of bonding her with the life growing in her womb. She knew then that she would do anything
for her baby, and she had wanted to experience every moment of labour, too, to know that she had done the best for her child.

Another contraction was hovering, about to grip her. She held her breath and braced herself, then closed her eyes as it rose
to a crescendo. Every muscle in her body clenched until she was sure her bones would break. She felt light-headed and wanted
to scream. Maybe they were right; maybe she couldn’t do it on her own after all.

‘OK, call the anaesthetist. Let’s do it now,’ she said, gasping, then turned onto her side and drew her knees towards her
chest. Her eyes filled with tears.

Debbie picked up the phone and spoke calmly. ‘I have another epidural here for you.’

Anna heard herself being reduced to just another nameless patient, just a procedure. As she felt her self slipping away, she
couldn’t shake the feeling that she had failed.

* * *

Once the epidural was in, she rested on her back on the bed. She was amazed at how quickly it had worked and how much stronger
she felt without the pain, though she wouldn’t admit it out loud. Her abdomen and legs were numb; she could hardly move. She
rested her hands on her belly to feel it tightening, reassuring herself that her body was still doing what it should. She
watched the machine beside her churn out a long strip of paper graphing the peaks and troughs of her contractions. It didn’t
seem as though it was connected to her belly, to her baby.

Tony was sitting in the corner, playing with something on his phone. He looked up.

‘Are you all right?’ he said.

She nodded.

‘Why don’t you close your eyes, try to have a nap?’

‘I’m OK, I’m just resting.’

As Tony turned his attention back to his phone, she watched the clock on the wall, willing it to go faster, imagining that
it was going slow on purpose.

Debbie came over and uncurled the strip of paper, frowning as she scanned it. She wrote something down, then turned up the
drip again.

‘Debbie?’ she asked. ‘Can you turn it up, the volume, just so I can hear … the baby?’

‘Of course.’ The midwife fiddled with a button, then rearranged one of the monitors strapped to her, and there it was.
Ba boom, ba boom
. Her baby was still there.

‘I just need to do an internal examination, Anna.’ Debbie pulled on a pair of rubber gloves.

She nodded. Debbie lifted up her numb legs. She looked away while she was poked and pushed.

‘All done. Hope that wasn’t too uncomfortable.’ Debbie snapped her plastic gloves off.

‘No, it was OK. What’s happening?’

Debbie raised her eyebrows. ‘Well, that cervix isn’t behaving – it’s just not where I’d expect it to be.’

She wondered why medical staff were trained to talk to patients as though they were children. She felt her jaw tighten. She
wasn’t just irritated with Debbie, she was irritated with herself, her body. She knew that didn’t make sense, but if Debbie
reckoned that her cervix could misbehave, she had every right to be angry with it. She had a sudden surge of energy and pushed
down on the mattress with her hands to hoist herself up in the bed.

‘So what are we going to do then?’

Debbie turned back to the drip stand and pressed the black button again. ‘We’ll just keep going. I’ll check you again in two
hours.’

Two hours? She could have cried. She wanted to get out of bed and walk around, to use the bathroom instead of having a catheter
in her bladder. She wanted to have a shower or sit on the fit ball as she had planned. She tried to breathe deeply as a horrible
sense of suffocating claustrophobia settled on her. She felt as though she was stuck on a long flight, with no way to stretch
out without touching someone, no way of protecting her own space. But she could no more get up from this bed than open the
door of an aeroplane and step out.

She felt Tony watching her. She turned away from his gaze and closed her eyes. Tony pulled his chair across the floor towards
her; the grating noise drilled through her. He took her clammy hand and stroked it with his thumb. She was too warm now; he
was making her hotter. She knew he was only trying to help, but she just wanted to be left alone. She forced a smile, then
pulled her hand away.

But he stayed by her side.

Tuesday, 15 September 2009

As the sun started to rise, a cleaner arrived and began mopping the floor around Tony. Soon afterwards the full lights came
on to indicate that a new day had started. The next shift of nurses breezed in, bright and chatty, sipping coffee from cardboard
cups with plastic lids. He watched them huddle around the desk and make notes as a senior nurse worked her way through a pile
of patient files, talking and gesticulating. She spoke too softly for him to hear clearly, but he knew when she was describing
Anna’s case by the way the nurses all glanced over at him. The door to Anna’s room was propped open again, but a new policeman
was on the chair. Tony stroked Anna’s hand; her eyes were still closed.

Laying his head back down on the bed he tried to sleep. Some time later, he saw a group moving from bed to bed in the main
area. He recognised the tall, thin frame of Dr Hall, the registrar he’d spoken to yesterday. Maybe they had some test results
now, some explanation for Anna’s condition. He stood up and waited just outside the door where they couldn’t miss him as they
walked towards Anna’s room. Dr Hall nodded in his direction but said nothing as the group crowded into her room and stood
with their backs to Tony. He hovered, trying to see what they were doing, but there was no room for him, so he watched through
the small window as they examined her. Their voices were low, and he couldn’t hear what they were saying. He didn’t have the
energy to push his way in, to ask them to speak up. The doctors finished and filed
out, darting off to the next bed like a frightened school of fish. Dr Hall, however, paused beside Tony with an older, balding
man, who held out his hand.

‘Mr Patton, I’m Dr Cooper, the consultant here in Emergency. Come with us, please, so we can have a quick talk.’

Tony nodded, suddenly feeling intimidated. He followed them down a passageway to a small, windowless room with two sofas crammed
into it. Dusty yellow silk flowers drooped from a vase on a small white formica coffee table against the wall. Dr Cooper and
Dr Hall sat on one sofa; he sat on the other. He rearranged the cushions to make more room, but his knees still practically
touched Dr Hall’s.

Dr Cooper asked the same questions Dr Hall had yesterday and he wearily repeated the same answers. There was nothing more
he could tell them.

‘Mr Patton —’

‘Tony.’

‘Tony, as you know, we’ve monitored Anna overnight, and we’ve been waiting for the test results. The good news is that we
can’t find anything medically wrong with her. Her head CT is normal, her temperature is good now, her blood tests are all
normal.’

‘Oh.’ While he was relieved, part of him was disappointed. It would be easier if the doctors had found something wrong with
Anna, something tangible, something with a name.

‘The next thing we have to rule out is any psychiatric condition,’ Dr Cooper went on.

His head snapped up. ‘But what about shock or something? You know, if someone’s attacked her or taken Jack from her. That
would explain the way she reacted.’

The consultant nodded. ‘If that was the case – and I don’t think it is – then the psychiatrist is still the best person to
help us. There’s no physical reason for her to be so unresponsive, and we haven’t found any evidence that she’s been assaulted
—’

‘But she’s covered in bruises and cuts!’

‘Yes, but they don’t look like they were done by a person or a weapon. I think they’re just from the rocks.’

He rubbed his forehead. He felt as though he was losing, running out of ways to make this man understand. ‘Then maybe they
just snatched the baby and she fell or something …’

Dr Cooper took a deep breath. ‘Tony, you’re right, that could have happened; the police will be looking into all possibilities.
But you’ve told us that she hadn’t been sleeping, that she’d seen her GP who gave her tablets – we must rule out significant
mental illness.’ He looked at Dr Hall, then back to Tony. ‘The police have probably asked you this already, but did you ever
worry that Anna could be a danger to herself … or to Jack?’

He looked at each of the doctors in turn. Did they really believe that she was capable of hurting her son? ‘No! Never! She’d
never hurt him – or herself – in a million years. Jesus, I can’t —’

‘OK.’ Dr Cooper held up his hands as if they could deflect Tony’s incredulity. ‘I’m sorry, it’s a standard question when people
have been very depressed.’

Weren’t they listening? ‘But she hasn’t been very depressed, I’ve told you.’

Dr Cooper’s pager beeped rudely. Tony wondered if he’d set it off deliberately so that he had an excuse to leave. He couldn’t
imagine doctors enjoyed this sort of conversation; it must be much easier to hand someone a prescription or give them an injection.
Regardless, he was glad of the few seconds it gave him to breathe, to think.

Dr Cooper looked up from his pager. ‘I’m sorry, Tony, but I have to go. Do you have any final questions?’

He was silent for a moment. His head was full of questions but Dr Cooper wasn’t going to answer them. He shook his head.

‘Just wait here. Dr Hall will page the psychiatry team – they’ll come straight away.’

He blinked, then held out his hand. ‘Thank you, doctor.’

* * *

Tony waited in that small, windowless room. He rubbed at the grainy silk petals of the fake plant to clean some of the dust
from them. He turned his phone back on and listened to his voicemail. The police, his parents, Wendy, a few teary messages
from friends and family who’d heard what had happened. He deleted them all, then called his parents’ number. His mum answered
on the first ring.

‘Anthony! Are you all right?’

‘Yeah, yeah. I’m still at the hospital. I’m sorry about last night, I just couldn’t face seeing anyone.’

‘For God’s sake, don’t worry about that. We waited a few hours, but they told us you’d fallen asleep so we went home to freshen
up – we wanted to let you rest. How’s Anna this morning? Any change?’

‘Oh Mum, I don’t know what’s going on. They say she’s physically OK. I’m waiting to see a psychiatrist. The doctors seem to
think that she could have done this deliberately.’ He spoke in a monotone; the idea of Anna harming Jack was so ridiculous
that he couldn’t find any anger. Let them do their assessment, and soon enough they’d find out they were wrong.

‘Has she said something? Is that why they think that?’

‘She hasn’t said anything. They knocked her out with some drugs last night, they said she was screaming. And then they wonder
why she can’t talk or wake up from this. They don’t get it! I can’t keep up with it all.’ He swallowed hard and rubbed his
face as his voice cracked. ‘Sorry … it’s just …’

‘What can we do? I’ll come straight away —’

‘No. I need to stay here, I just need to sort this out. She hasn’t woken yet. It’ll kill her, Mum, when she realises …’ He
heard Ursula take a sharp breath in, but she let him carry on. ‘Some detective left a message – they want to go to the house
and have a look around. Can you go and let them in? The spare key —’

‘Of course. I know where it is now.’

‘And Wendy’s getting in at about midday – can someone pick her up? I don’t know when I’ll be done here.’

‘Yes, yes, of course, don’t worry, we’ll sort it out …’

He heard footsteps approaching. ‘Thanks, Mum. I think the psychiatrist is here now, I’d better go. I’ll call you soon.’

‘OK. And Anthony … we’re just so very, very sorry.’

Tony closed his eyes and bit his bottom lip to stop tears from starting. Crying wasn’t going to help; there was too much to
sort out. He managed to say goodbye, then put his phone back in his pocket as two men entered the room.

The taller of the two wore dark grey chinos and a checked blue business shirt, open at the neck. ‘Mr Patton, I’m Dr Paul Murray.
I’m one of the psychiatry doctors, and this is one of our senior psychiatric nurses, Eamon Byrne.’

Tony nodded at the man standing just behind the doctor then turned his attention back to Dr Murray as the two men sat on the
couch opposite him.

‘We’re the psychiatry team working in the main hospital here,’ Dr Murray went on. ‘We see patients when the medical team is
worried that there may be a mental health issue affecting their physical health.’

‘They told me. But, look, I’ve been through this. You just have to take one look at her. She looks awful, she’s covered in
cuts and bruises, she can’t talk. She’s not making this up, this isn’t all in her head.’

Dr Murray looked at him steadily. ‘No one is saying that your wife is making this up, not at all. We know that physical and
mental health are closely linked: physical problems can cause emotional problems, and vice versa. We’re just here to see if
we can help the medical team untangle the issues a bit.’ He paused. ‘I’ve also heard about your son. I can’t imagine how difficult
this is for you.’

Tony sat forward, suddenly furious. No one really wanted to help Anna; they just wanted to blame her. ‘That’s why you’re here,
isn’t it? The police, that doctor, everyone thinks she did this. I’m telling you now, you’re wrong! There’s just, just no
…’ As quickly as it had come, his fury burned out, leaving smouldering disbelief.

Dr Murray leaned back on the sofa. ‘Please, calm down. That’s not the reason we’re here. This is a complex and difficult situation
and that just needs a few different perspectives. What the police do
is their issue: I’m here from a medical point of view. I have nothing to do with the police.’

Tony rubbed his face. ‘Look, I just want …’ He faltered. ‘I just want to know what happened to my baby … and I want Anna to
be OK.’ He realised immediately that he’d spoken about Anna as an afterthought.

‘I do too.’ Dr Murray said nothing for a few moments while Tony composed himself, then started again, gently. ‘Does Anna have
any history of mental health problems?’ At that, the nurse opened a pad of paper and clicked his pen.

Tony’s fists tightened and he clenched his teeth. ‘No! My God, I’ve been through this so many times, don’t you people talk
to each other? No! Anna has never been depressed, she was not depressed, she was just tired and couldn’t sleep. She saw her
GP two weeks ago, and she said Anna was fine. So no, this is not depression!’ He rested his head back on the sofa, exhausted.
The doctor and nurse glanced at each other. Tony knew what they were thinking: they thought he was naive, that they knew Anna
better than he – her own husband – did. And he knew that by being defensive, he was only convincing them in their belief that
there was something wrong with her. ‘Look, I’m sorry, it’s just been … It’s been a long twenty-four hours.’

Dr Murray spoke calmly. ‘I understand, Tony. I know this is really hard for you. What we might do is go and see Anna now,
see what we think, and come back and talk to you soon, OK?’

He nodded, but couldn’t look at them. He focused on a piece of lint on the arm of the sofa until they had left the room, then
he closed his eyes.

When they returned fifteen minutes later, the nurse, Byrne, was holding papers in his hand. ‘Sorry to keep you waiting,’ he
said as he and Dr Murray sat down.

‘That’s fine,’ he replied, trying to read the words on the paperwork.

Dr Murray cleared his throat. ‘From the history that we have, and from what we can see, I am worried that Anna is very, very
unwell. We need to get her out of the emergency department and admit her to the ward for more specialised care.’ He hesitated.

Tony knew what was coming next; there was no point fighting it. Suddenly, every muscle in his body ached and he could barely
hold his head up.

Dr Murray continued, ‘And the most appropriate place is our psychiatry unit. Anna can’t make that decision for herself at
the moment, so I’m going to admit her under the Mental Health Act.’

‘What?’ He had no idea what that meant. He felt like he was under attack, with a new assault being hurled at him every minute.

‘It means that I am making the decision for her, and if she were to try to leave, then I would have to stop her. I can do
that because I believe she is suffering from a severe mental illness, and that mental illness means she is a danger to herself
and others. Does that make sense?’

Tony pressed his fingertips into his temples and knew he owed it to Anna to at least try to protest. ‘She’s not dangerous.
And look at her, she’s not going anywhere – she can barely move.’

Dr Murray continued as if he hadn’t heard. ‘On the ward, another psychiatrist will see her. And if they agree with me, Anna
will stay there under the Mental Health Act until we make further decisions about her treatment.’

Byrne handed Tony the bundle of paperwork. ‘This explains everything in writing.’

He took it, then dropped it on the sofa next to him without looking at it. The decision had clearly already been made. ‘What
about the police? They said something about an interview.’

‘I know,’ Dr Murray said. ‘Don’t worry, they can’t interview her until she’s better. She’ll be under our care and supervision
until she’s well enough.’

He thought about the policeman guarding Anna’s door, the police at the beach, the police who might be going through his house
at this very moment. They were hovering around, waiting to pounce. He hadn’t managed to keep Jack safe; he needed to try
harder to protect Anna. Perhaps committing her to a psychiatric ward was the only way of keeping the police from her.

‘Do what you need to do,’ he said at last.

‘Great. We’ll just organise the bed and someone to take her up there.’ Dr Murray looked at Byrne, who nodded, leaning forward.

‘Tony, we’ll give you a call later when she’s settled in. Why don’t you go home and have a shower, something to eat, then
come back and see her on the ward?’

Tony nodded slowly, realising he was still in his work clothes. He looked at his suit pants, and couldn’t believe that it
was only yesterday that he’d kissed Jack goodbye and gone to work. Jack’s face flashed in front of him; suddenly he no longer
cared what happened to Anna. He felt sick. ‘I think I will go now, for a little while. I’m sorry … I’ve got so many things
to do.’