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I quite see the comedy of someone who had always resisted mechanistic accounts of the universe deciding that his life wasn’t complete without a car. On the other hand, if I didn’t grab the steering wheel with both hands, the joke would be on me for all time. I’d never be able to take charge of my own life. If I didn’t make it to the driver’s seat then I would never be more than a passenger, dependent on the good will of others. A finite quality, as I had already understood. The people who looked after me had limited stocks of patience, and for all I knew they were more forbearing than most. I had never experienced what it was to carry a burden — and that was the whole point. My only experience of burdens was of being one, and I couldn’t claim to have unlimited patience either, in that rôle.

Yod Hé Vau Hé!

By the time I returned to Wexham Park for my second dose of agony I was armed with new expletives. I didn’t want to amuse the staff with amateur swearing a second time. When the pain came I would try, however distressed and disoriented, to invoke the symbolic tetrad as explained in The Tarot, represented in the Mysteries of Memphis and Thebes by the four aspects of the sphinx (man, eagle, lion, bull) and also by the four elements. I planned to cry out Yod Hé Vau Hé, visualising the seductive shapes of the Hebrew letters in the book. I practised writing them out on the backs of envelopes and leaving them round, just to show that doctors didn’t have a monopoly on mysterious scribblings. I too could play that game.

I left The Tarot conspicuous by my bedside when Mr Arden the surgeon came to give me his pre-operative briefing. This was a pep talk which didn’t leave me with much pep, now that we both knew the flintiness of the material that was waiting for him beneath the veneer of skin. I remember him saying, ‘Orthopædics is a fairly brutal business.’ He was apologising in advance. He promised he would use the saw wherever he could, and only break what he must of my concrete hip. If he noticed the book he didn’t say anything. This was rather disappointing, but it’s the sad fact that high professional accomplishment doesn’t necessarily broaden the mind. The Top Man in Granny’s sense, someone who had soared so high in his medical specialty that he had transcended Dr and become mere Mr again, could still be almost mediocre, viewed in his other aspects. No doubt there were times in my teens when I was downright snooty. I was working very hard to feel superior to the man who planned to crack open one of my hips for the second time.

The pre-operative ritual had changed by the time of my second hip-cracking. It was no longer necessary, apparently, to shave my groin ahead of time.

There was no explanation given. By then I should have realised that explanations were not available on the National Health. It seemed a bit odd, all the same. If it was such a vital procedure last time, then why not now? What had changed? Perhaps I’d gained some immunity from infection along the way. If so, how did they know?

I felt pretty silly asking why I wasn’t having this intimate service rendered — as if I was anxious to go under the barber’s blade as well as the surgeon’s. I certainly had more of a crop of pubic hair than I had had the previous year. My personal experience didn’t put me in a position to refute the old-wives’-tale that shaved hair grows back with twice the force.

Fingers in the till of oblivion

There was something I thought I remembered about the anæsthetist on the first hip operation — not the time I had had the intravenous dose to which I was so disastrously allergic, but the second try with gas.

I remembered the anæsthetist having a lovely big beaky nose, a real schnozz, and he said cheerfully, ‘I’ll just make sure this mask is the right size for you!’, slipping it playfully over his own giant conk before fitting it over mine, taking a good old sniff in the process. Was I remembering right? Could that possibly be professional conduct?

Of course anæsthesia distorts perception of its very nature, and after I came round I was too busy trying to surf the waves of pain to be sure of my memories. This time I determined to notice everything, to participate in the experience to the fullest degree and forget nothing that happened, right up to the moment that the mask of consciousness slipped from my face.

I remember the mask itself seeming to grow huge as the gas took effect, and everything becoming unreal and full of echoes. I even think I struggled, trying to kick and move my arms to fight the anæsthetist off.

But it was the earlier bit that was more interesting. This time he didn’t say he was testing the fit of the mask, he said he was testing the flow of the gas, but yes, once again he took a good sniff on his own account before it was my turn.

Later, after I had crawled out of the trench of pain into which Mr Arden, summoning up all his professional skill, had tenderly lowered me, I asked Mum about what I had seen. She didn’t seem at all surprised. Apparently it’s a well-known professional hazard, liable to catch up with you in the long run. Anæsthetists don’t exactly fall asleep on the job, but they can’t always resist the temptation of dipping their fingers in the till of oblivion.

I think I kept to my resolution of using Mouni Sadhu’s The Tarot as my own personal dictionary of mystical expletives. I believe I kept ‘fucking buggers’ up my sleeve for other emergencies. The nursing staff looked at me a little strangely, which was probably no bad thing. I wanted to sound in my agony like an Adept uttering words of power rather than a schoolchild howling.

The man in the next bed when I was installed back at CRX was Mr Thatcher, a nice man who was recovering from having his gallstones out. He had been promised they would give him the stones in a jar, to take home with him when he left. He offered to let me take a look when they did. I was looking forward to it. Apparently there’s a lot of individual variation in the size, colour and texture of gallstones. ‘Some people,’ he told me, ‘have just one, but it looks like a mahogany doorknob. Other people just have a handful of gravel.’ Somehow it was immediately obvious that he was over towards the doorknob end of the gallstone spectrum.

Glottal-stop gurgle

Most of my conversations with Mr Thatcher revolved around gratifyingly adult subjects: sex, money and alcoholic drink. Because I was anæmic and underweight, Ansell prescribed me a bottle of beer every evening. She had upped the stakes from wholemilk yoghurt. Now it was up to Mackeson to build me up.

I didn’t like the beer, it was nasty stuff, but I loved having it. Ansell must have known what a thrill it was for a teenager in a-certain-amount-of-discomfort to be downing beer on doctor’s orders. Mr Thatcher was certainly jealous of my evening prescription, the medicine which came with a bottle-opener, and a nurse to work it.

When my medicine arrived, Mr Thatcher would launch into a lip-smacking rendition of the familiar advertisement for Mackeson. ‘Looks good …’ he would say, in slow tempo and countryman’s tones, ‘tastes good … and by golly it does you good.’ Imitating in fact the tones of Bernard Miles, unforgettably frightening Long John Silver on stage and patron of the Vulcan School. Obligingly I would make a glottal-stop gurgle as I swallowed the beer, which was so peatily sweet it did indeed taste like medicine.