Obviously it would be useful if doctors could quantify the amount of pain caused by a particular procedure, so as to compare it with other routes to the same therapeutic objective. Patients might eventually be offered a choice between paths through pain, in which personal preference would play a part. There are those who would opt for the agony-sprint, others for the long haul of sub-acute torment. Torturers of course could make use of the same figures in their own calculations.
An attempt was made at the University of Uppsala in the 1950s, with the participation of local hospitals, to codify responses to pain. In practice the answers people gave were inconsistent beyond the resolving power of statistical correction. It was impossible to screen out the variables, even after the questionnaires were twice redesigned. Pain itself seems to be mutable, so that sometimes it becomes more intense with repetition, while at other times it dulls into numbness. Flirtatiously the toothache lies low, the moment it has led you trembling to the dentist’s chair.
The Uppsala research led nowhere, in the end. It offered a poor return on the krona. So all that remains of the idea is the name of an imaginary standardised unit of pain — the dolor — while the actual project of a workable dolorific calculus was abandoned. So Mum and I couldn’t have a conversation, seasoned patient to ex-nurse, on the level of ‘Mum, it was agony! It was an 88!’ — ‘You poor thing, JJ. Childbirth only averages 55 — and I should know!’ Our exchanges were much vaguer, with tears on both sides.
Deprived of Mum’s attention for those few seconds, Audrey saw her chance of winning it back with interest. She went very quiet, which should have made us suspicious right away, but Mum was preoccupied with soothing me.
Nurses were popping in and out of the side ward every couple of minutes, and Audrey must have taken advantage of one such entrance and exit to slip out herself. So far she only did what any stroppy six-year-old would have done, but in the latter part of the escapade she showed her quality. When Mum had raised the alarm and charged off to lead the search party, she somehow managed to sneak back to where I was. From my position in bed, traumatised and now also upstaged, all I saw was the door of the side ward swinging open and then closed. No head showed at my level. Then a little later Audrey gave a loud and very stagey yawn and stood up, saying she had had ever such a lovely sleep and where was her Mummy? I pressed the bell for a nurse and slowly the fuss died down, with Audrey sticking to her story that she had never left the room. She even said that I had seen her, which was physically impossible, though it also meant I couldn’t flatly contradict her story, however little I was tempted to believe her. I could see Mum wavering. It wasn’t that she was convinced, she just preferred to think that she wasn’t sharing her home with a manipulative little madam.
Audrey was back in a merry mood. She seemed to think the whole thing was funny, which in a way it was. Mum had longed for years with so much intensity to have a daughter. She dreamed of the completion a female child would bring. She had wanted to be so close to someone that they could almost hear each other’s thoughts, but now that it had come true she didn’t really enjoy it that much.
It was a little breakthrough for Audrey. She had always been a good liar, but now she was an inspired one. She had acquired the knack of being the first believer of her own untruths, letting them radiate unstoppably outwards from that secure core of falsehood.
If Mum really wanted a child who couldn’t get away, I was much the better bet — not that I consented to any such transfer of her hopes, but I could see the truth of the situation. Audrey was already a lost cause. She was supremely well armed, with slyness and subterfuge. She exercised charm relatively late in any negotiation, just before the nuclear tantrum of last resort.
Ice cream and jellies all the way
The diet for traumatised throats favoured by at least one of the matrons at Vulcan (a fanatical advocate of dry toast as a healing agent) hadn’t reached Wexham Park, or if it had the staff felt too guilty and embarrassed by my particular case to implement it. It was ice cream and jellies all the way, and I didn’t need to look toast in the face for weeks.
It took me a week or two to recover from the assault on my throat — slow progress. Another day another dolor. I didn’t have all that much incentive to get better, not when I was only getting back to square one. Finally I was pronounced ready for a second go at being operated on. The operation to install the first McKee pin, referred to by others but not by me as my ‘op’.
I rather resented the abbreviation. I felt that styling the coming ordeal was my privilege rather than anyone else’s. Others should follow my lead and say ‘operation’, unless and until I gave the signal to authorise the short form. They should defer to me in this matter, since it was the only little bit of surgery in my power.
It wasn’t Jack Juggernaut but another nurse who shaved my groin when it became time again. Not that my pubic thatch had made much of a comeback in those weeks. It was still at the itchy stage. I wondered if the change of personnel showed that I was in disgrace for my excitement the last time I was shaved.
The new nurse was the same delicious colour as Jack Juggernaut, and had a lovely faint smile playing about her lips while she went to work. I wasn’t worried — that is, I was mildly anxious about the operation but not about the shaving. Later I found out she was Jack’s sister. I wondered madly if they had compared notes about Tom Dooley, hardly likely in their culture but something which would nevertheless explain the smile. When she saw him, Tom was dozing even before the anæsthetist arrived with the gas. Naturally it was gas this time.
Mum’s warning about how difficult it was to sew together three pieces of cloth — and therefore also of skin — had given me pause, but I wasn’t seriously bothered, even after the botch-up of the anaesthetic. I’d seen the excellence of Mum’s work as a seamstress. She rose to every challenge, and there was no reason to think that the surgeon was any less skilled. Mum wasn’t even a professional dressmaker, just a gifted amateur working for pin money, so it made sense that there should be many levels of expertise beyond hers, Himalayas beyond the foothills where she practised her useful domestic skills. A surgeon operating at a proper hospital must be more than just handy with the scissors and the pins and the needles, with basting and seams. He would be a scientist who was also an artist, a visionary thinker, a Leonardo of the surgical blade. Would my case even be distinctive enough to hold his interest? I hoped at least it would take his mind off the cryptic crossword he had been doing before he entered the sterile area. It would be sad to disappoint a person of such qualities.
I wasn’t entirely wrong. The surgeon had skills. He wasn’t intrinsically a bodger. Maybe the problem was simply that we were treating the body as a machine, and if the body is a machine then pain is one of the things it produces. The surgeon who operated on me specialised in arthroplasties, in McKee pins, metal on metal. He even had experience in performing them on patients with Still’s Disease. So he was a specialist within a specialism. It’s just that I turned out to be, once again, even more special than anyone had anticipated.
I was sick to the back teeth of special, but I couldn’t make myself ordinary by an act of will or I might have been tempted to try it a long time ago, provided it was on the Ellisdons mail-order catalogue basis, On Approval, your money back guaranteed if not perfectly satisfied.
The worst of the whole darn bunch
I surfaced, by incredulous degrees, from the anæsthetic, into an experience of pain that was beyond anything I had suffered at Manor Hospital, where they tickled the bone with a little hook to get a biopsy sample, or at CRX when Miss Krüger had made us dance for her pleasure. It was worse because it was constant, without modulation. It was some time before I could bring it down into something as mild as an internal scream of betrayal. Ansell had lied to me. Ansell of all people. Et tu, Barbara! If this was ‘a certain amount of discomfort’, then she was a devil who enjoyed making people hurt, who got a thrill out of offering reassurance and then kicking it away, leaving me to dangle on a rope of pain. She was a compendium of all the ghouls I had ever known or heard of: she was Miss Krüger with her invisible pointe shoes of agony, she was Vera Cole wielding her razor on sick boys because she hated to see them suffer, she was Judy Brisby with her nerve punches, she was Anna Mitchell-Hedges letting demons out of their travelling-case. She was the worst of the whole darn bunch because she had seemed so much like a friend.