Having finished reading, he leaned forward with the faintest thaw in his expression. ‘How are you feeling, Caitlin?’
She shrugged, then was silent for some moments. Lynn waited for her to speak. Caitlin extracted her hand from her mother’s and began scratching the back of each hand in rotation.
‘I itch,’ she said. ‘I itch everywhere. Even my lips itch.’
‘Anything else?’
‘I’m tired.’ She looked sulky suddenly. Her normal look. ‘I want to feel better,’ she said.
‘Do you feel a little unsteady?’
She bit her lip, then nodded.
‘I think Dr Hunter has told you the results of the tests.’
Caitlin nodded again, without making eye contact, then rummaged in her soft, zebra-striped handbag and pulled out her mobile phone.
The consultant’s eyes widened as Caitlin stabbed some buttons, reading the display. ‘Yes,’ she said distantly, as if to herself. ‘Yup, he told me.’
‘Yes,’ Lynn stepped in hastily. ‘He has, he’s – he’s told us the news – you know – what you have told him. Thank you for seeing us so quickly.’
Somewhere outside, along the street, a car alarm was shrieking.
The consultant looked at Caitlin again for a moment, watching her send a text and then put the phone back in her bag.
‘We have to act quickly,’ he said.
‘I don’t really understand exactly what has changed,’ Caitlin said. ‘Can you sort of explain it to me in simple terms? Sort of, like,
idiot
language?’
He smiled. ‘I’ll do my best. As you know, for the past six years you’ve been suffering from primary sclerosing cholangitis, Caitlin. Originally you had the milder – if you can call it that – juvenile form, but recently and very swiftly it has turned into the advanced adult form. We’ve tried to keep it under control with a mixture of drugs and surgery for the past six years, in the hope that your liver might cure itself – but that only happens very rarely, and I’m afraid in your case it has not. Your liver has now deteriorated to a point where your life would be in danger if we did not take action.’
Her voice very small suddenly, Caitlin said, ‘So I’m going to die, right?’
Lynn grabbed her hand and squeezed hard. ‘No, darling, you are not. Absolutely not. You are going to be fine.’ She looked at the doctor for reassurance.
The doctor replied impassively, ‘I’ve been in touch with the Royal South London Hospital and arranged for you to be admitted there tonight for assessment for transplantation.’
‘I hate that fucking place,’ Caitlin said.
‘It is the best unit in the country,’ he replied. ‘There are other hospitals, but this is the one we work with normally from down here.’
Caitlin rummaged in her bag again. ‘The thing is, I’m busy tonight. Me and Luke are going to a club. Digital. There’s a band I need to see.’
There was a brief silence. Then the consultant said, with far more tenderness than Lynn had imagined he was capable of, ‘Caitlin, you are not at all well. It would be very unwise to go out. I need to get you into hospital right away. I want to find you a new liver as quickly as possible.’
Caitlin looked at him for a moment through her jaundiced yellow eyes. ‘How do you define well?’ she asked.
The consultant, his face thawing into a smile, said, ‘Would you really like my definition?’
‘Yes. How do you define
well?’
‘Being alive and not feeling sick might be a good place to start,’ he said. ‘How does that sound to you?’
Caitlin shrugged. ‘Yup, that’s probably quite good.’ She nodded, absorbing the words, clearly thinking about them.
‘If you have a liver transplant, Caitlin,’ he said, ‘the chances are good that you will start to feel well again and get back to normal.’
‘And if I don’t? Like – don’t have a transplant?’
Lynn wanted to butt in and say something, tell her daughter just exactly what would happen. But she knew she had to keep silent and play this out as an onlooker.
‘Then,’ he said baldly, ‘I’m afraid you will die. I think you have only a short time to live. A few months at the most. It could be much less.’
There was a long silence. Lynn felt the grip of her daughter’s hand suddenly and she squeezed back, as hard as she could.
‘Die?’ Caitlin said.
It came out as a trembling whisper. Caitlin turned to her mother in shock, stared at her face. Lynn smiled at her, unable to think for a moment of anything she could say to her child.
Nervously, Caitlin asked, ‘Is this true? Mum? Is this what they already told you?’
‘You are very seriously ill, darling. But if you have a transplant it will be fine. You’ll be well again. You’ll be able to live a completely normal life.’
Caitlin was silent. She withdrew her hand and put a finger in her mouth, something Lynn had not seen her do in years. There was a beep, then a fax machine on a shelf near the doctor printed out a sheet of paper.
‘I’ve been on the Net,’ Caitlin said abruptly. ‘I Googled liver transplants. They come from dead people, right?’
‘Mostly, yes.’
‘So I’d be getting a dead person’s liver?’
‘There is no absolute guarantee we’ll be lucky in getting you a liver at all.’
Lynn stared at him in stunned silence. ‘What do you mean, no guarantee?’
‘You both have to understand,’ he said in a matter-of-fact way that made Lynn want to rise up and slap him, ‘that there is a shortage of livers and that you have a rare blood group, which makes it harder than for some people. It depends if I can get you in as a priority – which I am hoping I can. But your condition is technically “chronic” and patients with “acute” liver failure tend to get priority. I’ll have to fight that corner for you. At least you tick some of the right boxes, being young and otherwise healthy.’
‘So, if I get one at all, it’s likely I’m going to spend the rest of my life with a dead woman’s liver in me?’
‘Or a man’s,’ he said.
‘How great is that?’
‘Isn’t that a lot better than the alternative, darling?’ Lynn asked, and tried to take her hand again, but was brushed away.
‘So this is going to be from some organ donor?’
‘Yes,’ Neil Granger said.
‘So I would be carrying around for the rest of my life the knowledge that someone died and I’ve got a bit of them inside me?’
‘I can give you some literature to read, Caitlin,’ he said. ‘And when you go up to the Royal, you will meet a lot of people, including social workers and psychologists, who will talk to you all about what it means. But there is one important thing to remember. The loved ones and families of people who have died often take great comfort from knowing that the death wasn’t completely in vain. That that person’s death has enabled someone else to live.’
Caitlin was pensive for some moments, then she said, ‘Great, you want me to have a liver transplant so that someone else can feel good about their daughter’s, or husband’s, or son’s death?’
‘No, that’s not the reason. I want you to have it so I can save your life.’
‘Life sucks, doesn’t it?’ Caitlin said. ‘Life really sucks.’
‘Death sucks even more,’ the consultant replied.
13
Susan Cooper had discovered that there was a fine view from this particular window, just past the lifts on the seventh floor of the Royal Sussex County Hospital, across the rooftops of Kemp Town to the English Channel. All today, the sea had been a brilliant, sparkling blue, but now, at six o’clock on this late November evening, the falling darkness had turned it into an inky void, stretching to infinity beyond the lights of the city.
She was staring out at that vast blackness now. Her hands rested on the radiator, not for the warmth it gave off but merely to support her drained body. She stared silently, bleakly, through the reflection of her face in the window, feeling the draught of cold air through the thin glass. But feeling little else.
She was numb with shock. She could not believe this was happening.
She made a mental list of the people she still needed to call. She’d dreaded breaking the news to Nat’s brother, to his sister in Australia, to his friends. Both his parents had died in their fifties, his father from a heart attack, his mother from cancer, and Nat used to joke that he would never make old bones. Some joke.
She turned, padded back to the Intensive Care Unit and rang the bell. A nurse let her in. It was warmer in here than out in the corridor. The temperature was maintained at 34- 35°C, high enough for the patients to lie in hospital pyjamas, or naked, without any risk of catching cold. It was an irony, she thought, although she did not dwell on it, that she had once worked as a nurse here, in this very unit. It was in this hospital that she and Nat had met – shortly after he had started as a junior registrar.
She felt movement inside her. The baby was kicking.
Their
baby. Thirty weeks old. A boy.
As she turned right, walking past the central nursing station, where a prosthetic leg had been abandoned on a chair, she heard the swishing of a curtain being pulled. She looked across at the far corner of the ward and her heart lurched inside her. A nurse was drawing the blue privacy curtain around Bed 14, Nat’s bed. Sealing it from prying eyes. They were about to start some new tests and she wasn’t sure she had the courage to be with him while they did. But she had sat by his side almost all day and she knew she had to be there now. Had to keep talking to him. Had to keep hoping.
He had compound and depressed skull fractures, a lesion to the cervical region of his spinal cord that was likely to leave him a quadriplegic if he survived, as well as an almost irrelevant – at this stage – fractured right clavicle and fractured pelvis.
She hadn’t prayed in years, but she found herself praying repeatedly today, in silence, always the same words: Please, God, don’t let Nat die. Please, God, don’t let him.
She felt so damn useless. All her nursing skills and she could not do a thing. Except talk to him. Talk and talk and talk, waiting for a response that did not come. But maybe now would be different…
She walked back across the shiny floor, passing a hugely fat woman in the bed to her right, the rolls of flesh on her face and body looking like the contours of a 3-D map. One of the nurses told her the woman weighed thirty-nine stone. A sign on the end of the bed said DO NOT FEED.
To her left was a man in his forties, his face the colour of alabaster, intubated, a forest of wires taped to his chest and head. He looked, to her experienced eye, as if he had recently come out of heart-bypass surgery. There was a large, cheery get-well card propped on an instrument table beside him. At least he was on the mend, she thought, with a good chance of walking out of this hospital, rather than being carried out.
Unlike Nat.
Nat had been in steady decline throughout the day and, although she was still clinging to a desperate, increasingly irrational hope, she was starting to sense a terrible inevitability.
Every few minutes her phone, turned to silent, vibrated with yet another message. She had stepped out to reply to some. To her mother. To Nat’s brother, who had been here this morning, wanting an update. To his sister in Sydney. To her best friend, Jane, whom she had called tearfully this morning, an hour after arriving here, telling her that the doctors weren’t sure whether he would live. Others she ignored. She did not want to be distracted, just wanted to be here for Nat, willing him to pull through.
Every few moments she heard the
beep-beep-bong
of a monitor alarm. She breathed in the smell of sterilizing chemicals, catching the occasional tang of cologne and a faint, background note of warm electrical equipment.
Inside the curtained space, propped up in a bed that had been cranked to a thirty-degree angle, Nat looked like an alien, bandaged and wired, with endotracheal and nasogastric tubes in his mouth and nostrils. He had a probe in his skull to measure intracranial pressure, and another on one finger, and a forest of IV lines and drains from bags suspended from drip stands running into his arms and abdomen. Eyes shut, he lay motionless, surrounded by racks of monitoring and life-support apparatus. Two computer display screens were mounted to his right, and there was a laptop on the trolley at the end of the bed with all his notes and readings on it.
‘Hello, darling,’ she said. ‘I’m back with you.’ She stared at the screens as she spoke.
There was no reaction.
The exit tube from his mouth ended in a small bag, with a tap at the bottom, half filled with a dark fluid. Susan read the labels on the drip lines: Mannitol, Pentastarch, Morphine, Midazolam, Noradrenaline. Keeping him stable. Life support. Preventing him from slipping away, that was all.
The only signs that he was alive were the steady rising and falling of his chest and the blips of light on the monitor screens.
She looked at the drip lines into the back of her husband’s hands, and the blue plastic tag bearing his name, then at the equipment again, seeing some machinery and displays that were unfamiliar. Even in the five years since she had left nursing for a commercial job in the pharmaceutical industry, new technology that she did not recognize had come in.
Nat’s face, a mess of bruises and lacerations, was a ghostly shade of white she had never seen before – he was a fit guy who played a regular game of squash, and normally always had colour in his face despite the long – crazily long – hours of his job. He was strong, tall, with long, fair hair, almost rebelliously long for a doctor, not long past thirty and handsome. So handsome.
She closed her eyes for an instant to stop the tears coming. So damn sodding handsome. Come on, darling. Come on, Nat, you are going to be OK. You are going to get through this. I love you. I love you so much. I need you. Feeling her stomach, she added,
We both need you.
She opened her eyes and read the dials on the monitors, the digital displays, the levels, looking for some small sign that could give her hope, and not finding it. His pulse was weak and erratic, his blood oxygen levels way too low, brainwaves scarcely registering on the scale. But surely he was just asleep and would wake up in a moment.