Reading about the procedures that took place in Harefield, the technical advances, doesn’t help. My heart thumps loudly, standing in for the mechanism of the clock that freezes time. As a metaphor the heart is too assertive; several of the Harefield administrators died, at work, of heart attacks. This is not surprising; the layout of the hospital, with its ‘oxygen storage’ sheds, its intricate system of paths and walkways, its sealed chambers, becomes a pictogram of the heart. I think of my father and grandfather dying suddenly, out of the blue, when their hearts gave out. At home, in a chair, after a shopping expedition; on the pavement, outside the house, after an uphill walk.
Because we have come here from the canal, with the motorway as our sound-strip, running at the edge of the frame, we see Harefield in terms of the drowned, of roadkill; a deepfreeze waiting for spare parts. Magdi Yacoub is the Egyptian virtuoso. Fate-defying surgical feats extend life beyond all reasonable expectation. Changes of heart. The ‘Domino Procedure’ during which hearts are shunted, person to person, in a frantic game of pass the parcel. Patients would, under certain circumstances, undergo full heart/lung transplants, even when their hearts were healthy, because combined transplants have proved more successful. The ‘spare’ heart would then be utilised in a second transplant operation.
In 1987 the first ‘triple’ (heart/lung/liver) was carried out at Harefield. A heart/lung transplant in 1983 cost around £25,000. Roughly the sum expended in servicing the empty Millennium Dome for one day (essential maintenance, security, utility bills, insurance, PR). The dead Dome ticks away, New Labour’s tell-tale heart, at £13 a minute, while Harefield fights to stay in the game. Hospitals, it has been declared, must become ‘self-governing’, part of a Trust within the NHS. They are obliged to provide a service that will attract the right clients, the ones who can pay. Income will then rise and hospitals will have ‘the freedom (within limits) to borrow money’.
We don’t know it, but this is another of our obituary circuits; Harefield is doomed. The news-spinners waited for 11 September 2001 before making their announcement: the hospital would close, it would be moved into town. Much more convenient. Valuable real estate could be released on to a market desperate for housing. A done deal.
Time whirls in tight vortices: ghosts of the big house, rose garden, sun-dial, are slow to decay; they are overwhelmed by the clamour of the Australian convalescents in their huts, the mortal theatre of transplant surgery. Lost lives. There are tales of patients, during that period when consciousness is lost, when they sink into meat-memory, blood forced around the body, functions taken over by machines; reveries of floating, becoming one with the orbital sunstream, the cars on the road. Rib cages split like broken toast-racks. For a short time there is no heart in the cavity. Arteries are outlined with radio-opaque fluid: a night map of the M25. After coronary artery bypass grafts, the graftee is confused, suffering from double vision, speech and thought out of synch. They’ve been given the wrong script. When the recovering patient can speak, when the tube has been removed from the trachea, he admits that several days have been ‘lost’. They’ve gone. They’ve entered the ecosphere of the parkland. Or so, walking slowly across the damp lawns, we imagine.
*
Among the unsolicited items that turned up in Jiffy bags, at the time when I was writing my book about the M25 walks, was a VHS tape with the label The Nine Lives of Tomas Katz. My agent (who sent it) had very little information to impart: ‘German subtitles’. There was no letter of explanation, no production notes. They had been mislaid. I wasn’t in a rush to play this one: an Ashes series was just beginning, there were video logs from my own road trips.
Muggy heat in the centre of London, unconvinced breezes (diesel backdrafts) in West Thurrock. I returned, exhilarated, from a trip to Purfleet. The photographer Effie Paleologou, seven months pregnant, was banged up in a cabin-sized room in the Ibis Hotel. Accompanied by a friend who could help with the hauling of equipment, she was undertaking a twenty-four-hour conceptual project: one minute of tape shot every hour, on the hour. Plus: three exposures (playing safe with F-stops) on her still camera. Behind this exercise, surveillance as art, lay Don DeLillo’s ghost story, The Body Artist.
She spent hours at the computer screen looking at a live-streaming video feed from the edge of a two-lane road in a city in Finland. It was the middle of the night in Kotka, Finland, and she watched the screen. It was interesting to her because it was happening now, as she sat here, and because it happened twenty-four hours a day, facelessly, cars entering and leaving Kotka, or just the empty road in the dead times. The dead times were best.
West Thurrock (the view over the Queen Elizabeth Bridge) was a seductive area to film. Visiting Effie had the added advantage of a run down the A13. The wobbly yellow chips outside McDonald’s at the Warner Centre, Dagenham. The Ford water tower. Container stacking yards, pylons. All my old favourites.
Effie’s high window, double-glazed, looked across a glinting paddock of cars waiting for export, the Purfleet refineries and storage tanks. Purfleet was the fabled site of Dracula’s abbey, Carfax. Distribution of blood has now become distribution of (Esso) petrol.
After watching the afternoon’s video diary — Lakeside, Ibis Hotel, A13 — I was ready to sample at least three of The Nine Lives of Tomas Katz. Katz was a good name, the name of the Brick Lane string shop, the last Hasidic enterprise in Bangla-town; the place where I had first seen the work of Rachel Lichtenstein.
The VHS, with its unexplained German subtitles, is credited, script and direction, to Ben Hopkins. It opens on the M25, a (sha)manic hitchhiker appears from nowhere (a hole in the ground), to wave down a passing London cab. Disbelief dutifully suspended, I let the tape run. There’s a tradition of road crazies, asylum escapees picking up unlikely lifts. Our cabbie is no Ralph Meeker. He’s a fat man. The hitchhiker, dressed in a long coat hung with bones, looks like an English Civil War veteran, a Digger on his way to St George’s Hill, near Wey-bridge. He’s a dream-catcher, a shape-shifter. He summons the cabbie’s recurrent nightmare, a post-operative trauma involving the Happy Eater creature, a giant pink bug dripping the blood of the cabbie’s cannibalised child. The source of the dream, so the visionary explains, is the cabbie’s new heart — which was borrowed from a pig. ‘A baboon,’ the sweating driver insists. ‘It was a baboon.’
On the level of myth, road and heart were always interlinked. The orbital (going nowhere, being everywhere) motorway sweeps up London’s lucid dreaming. Harefield, with its reserve blood stocks, and Purfleet (with its vampiric traces) confirm the heart as metaphor. Blood is an international commodity, the base trade. Drained arms for asylum seekers and junkies, quality stock laid down by the wealthy. Pre-donation is the advised policy. Leaflets are distributed at all luxuriously appointed private hospitals, suggesting that ‘many people who have to undergo major elective surgery… now choose to deposit their own blood. This removes the risk of infection… Blood can be stored in our blood bank.’
Surgical procedures affect the way we picture the M25; ‘clotting’ in Harefield is twinned with sluggish traffic, stalled cars in the Heathrow corridor. Emergency lights flash. Cardiac arrest. The heart has its quadrants, dividing London into four unequal quarters. When they opened the skull of Ian Hacking’s mad walker, the man who paced his neurotic circuits, trying to fit ‘heavens and angels’ into the bowl of bone, they were searching for a road map, a physical explanation. Landfill sites in Essex (gunpowder mills, foot-and-mouth burning pits) damage the fragile balance. Road rage in Swanley. Disorientation in Surrey. The man who went blind but kept on driving along the hard shoulder. We have to learn to walk the damage, repair the hurt.