Sleight of Hand (13 page)

I told her that I was sorry but that I couldn't really talk, and she said that,
of course
, I wasn't alone.
Your girlfriend?
she asked, and I lied and said,
Uhuh
, as if someone was beside me and Cristina sounded disappointed but told me that she understood entirely and that she would just wait for me to phone her back another time.

But I was furious after that Chupy. I couldn't work out which annoyed me the most: you and Tom getting all cosy together, or Cristina somehow getting my number. And I couldn't decide whether to call her back or change my number. And I couldn't decide whether to call you back or not, and what I should say if I did. I couldn't work out what I would have to say to either of you in order to make Tom or Cristina vanish forever.

My first patient was the kind that would usually cheer me up – the kind I would usually laugh about with you when I got home.

He was a sixty year old fisherman with one of those inexplicably wealthy sons, and he wanted to know how best to cure his impotency. He couldn't get it up with his wife, he said, and his dilemma, and he was totally sincere babe, was whether he was better off with Viagra or, as his son had offered, a twenty-year-old Argentinian whore, and I was in such a bad mood that even advising him that combining the two would probably do the trick didn't cheer me up one bit, because you weren't back home for me to tell, and because I now had other things on my mind.

I have just finished packing my bag when Jenny enters the room and sits on the edge of her mother's bed. A little sunshine is leaking though a complex sky outside, catching flecks of floating dust in its rays.

“You've moved everything around,” she says, apparently noticing this for the first time.

“Yeah, as much as possible, I did.”

Jenny nods thoughtfully. “It's better,” she says.

“Well, at least you can lie in bed and look at the stars now.”

“No curtains,” she says.

“They're drying. On the line.”

“Right. Look. Have I upset you?” she asks. “Because, you know, I'm all over the place at the moment and I didn't mean to …”

I shrug and sit down beside her. I sigh deeply. “It's just … I thought I was helping. But I'm just on the outside really, aren't I? Because of everything that's happened. Which is fine. But you have Tom, and I think I should move on.”

“You
have
been a help,” Jenny says. “You've been brilliant.”

“Thanks.”

“And Sarah's loved you being around.”

“Yes. I've liked seeing her too. She's a great kid.”

“Where are you going now? To France, or back to Colombia?”

“I thought I'd head to the south coast for a few days. Have a look at Eastbourne. Maybe Brighton too, for old times' sake. But don't tell Tom.”

“No.”

“And then on to Nice. Ricardo wants me to look in on his flat.”

“God, does he still have that?”

“Yeah.”

“The same one? Overlooking the port?”

“It's rented of course, but yes.”

“I had no idea.”

“No.”

“And have you booked tickets and hotels and stuff?”

I shake my head. “I thought I'd do it as I go along.”

“Right.”

I frown at Jenny, picking up on some hidden motive. “Why?”

“I … look, I know I haven't been as nice as I should have been, right?”

“Really Jen, it's fine. You've got so much going on.”

“But … well … if you could …”

“Yes?”

“If you could stay till tomorrow.”

“Tomorrow?”

“Yeah, you know I have to go to London …”

“Oh, yes, right. And you want me to look after Sarah?”

“No, that's not it. No, Sarah will be in nursery and Susan can pick her up.”

“Then … ?”

“I think I need someone with me.”

“In London?”

“Yes. And Tom's working of course, so …”

“Right,” I say. I frown and glance a little regretfully at my packed bag. “Is there something
specific happening? Is there a specific reason, because …”

Jenny sighs and swallows. “I didn't want to tell you,” she says, rubbing her brow and looking out of the window. “It's not fair really. It's not fair on you.”

I touch her arm and she looks back at me, watery eyed.

“Jenny?” I prompt.

“It's
cancer,”
she says in a whisper.

“I'm sorry?” I honestly think that I have misheard her.

“It's cancer. A brain tumour.”

“You?”

“No the neighbour's cat.”

“The neigh … ?”

“Well of course
me.”

“I'm sorry, I mean …
God! Really?”

“Well, that's what they said anyway.”

“And that's the cause of the fits you had?”

“Yes. Pressure on the brain or something.”

“God.”

“Yeah.”

“Did they say anything else?”

Jenny nods and bites her lip.
“Yeah
, they did,” she says, her voice trembling and tears welling up. I sit and watch her face swell and wait for whatever's coming next.

“It's in a really difficult place,” she finally says.

“What do you mean, a diff …”

“Difficult to operate on. That's why he had to consult.”

“To consult?”

“With a colleague.” She clears her throat, then continues, “The guy I saw – the specialist – he had to talk to a colleague, about what to do. Because he
doesn't think they can take it out because of where it is.”

“So what's happening Tuesday?”

“Tuesday they decide. Or at least, Tuesday he
tells
me what they've decided.”

“Right. About what?”

“Oh, Mark, look, I don't know …” she says, her voice strangely flat. Tears are streaming down her cheeks though and I'm starting to cry as well. “I'm … I'm
scared,”
she gasps.

“Oh Jen.
Of course
you are. You should have told me.”

“I know. And I know it's not fair, but,
can
you?
Can
you come with me?”

“Of course,” I say. “You know I will.”

“I'm so scared,” she says again. “I'm so worried about Sarah.”

“Sarah?”

“Well if something happens …” Her body shudders and I turn towards her and take her in my arms. “If something happens to me,” she whispers. “What's going to happen to her?”

“It'll all be fine,” I say squeezing her as tight as I can and staring outside at the fast-moving clouds.

“Will it?” she asks. “Will it be fine?”

“Of course,” I say. “You'll see. It'll all be OK. They do miracles nowadays.”

For some reason, I am expecting Saint Thomas' hospital to be a decrepit old building on the outskirts of London, not a modern mega-complex opposite the houses of parliament. Equally, despite Jenny's warnings, I'm expecting Professor Batt to be a disheveled old man with a friendly bedside manner rather than a posh patronising twat.

Seated in his large, windowless office, he shows us Jenny's brain scan. It's the first time I have seen this and it provokes a sharp intake of breath. I had imagined something like the ultrasound scans they show on TV, where they say, “There, you can see his arm,” and the mother-to-be says, “Oh! Yes!” even though quite clearly, no one can see anything at all. But here, the dumpling-sized blob on Jenny's brain scan is terrifyingly, indisputably
there
.

Jenny sits in silence and stares at the blob and nods. “It looks bigger,” she says. “Has it got bigger?”

“It's the same scan, dear,” Professor Batt says, with barely veiled sarcastic undertones.

“Of course.”

“It's a pontine glioma,” he says, “but we'll need to take a tissue sample before we can know if it's malignant. We'll probably want to do a spect scan too.”

“What does that mean?” I ask. “A pontine glioma?”

“It's where it is, and the type of tumour,” he says, leaving me none the wiser.

“And a tissue sample, you say? So that's surgery?”

“Yes, keyhole. A tiny hole, here …” he points to the back of his head. “And then we take a tiny sample to see if the cancer cells are malignant. And if this is the primary tumour or if it has metastasised from elsewhere.”

“You mean there might be others.”

“There might.”

“And malignant is the worst kind, right?”

“Um … Well, malignant just means the cells are dividing and spreading.”

“Which is worse …”

“Well, the tumour would be growing in that case.”

“Which is worse than if it isn't though?”

“Well, yes.”

Jenny nods, and still says nothing, so I scan my sheet of paper for the questions with which Ricardo primed me.

“How many brain tumours do you operate on a year?” I ask. Ricardo was very specific that you should never entrust yourself to someone who isn't doing a
lot
of the specific kind of surgery that is required.

“Here, at the hospital? Or me personally?”

“Um … You, I suppose. If you're doing Jenny's surgery.”

“I'm afraid surgery isn't an option here, so …”

“Oh,” I say. Which is where Ricardo's questions cease to be useful.

“But I treat a few hundred brain tumours a year, if that's your question. With surgery, radiotherapy, chemo, and sometimes all three.”

“And
why
can't this one be removed with surgery?”

“Because of where it is – the pons.”

“The pons?”

“It's here,” he says, pointing at the scan. “It's the part of the brain that deals with breathing, and swallowing … critical functions. We don't go near it if we can help it. It's just too dangerous.”

“Right. But the keyhole thing is OK?” I ask.

“Yes. Well, pretty much … there's always risk, but we can go through the details later. We basically take a sample the size of a pin-head. Well, maybe a little more, but …”

“And if it's benign, she'll be OK, right?” I ask, trying to cling to the positive here.

Doctor Batt grimaces. “Not at all, I'm afraid.”

“But there's more
likelihood
that she'll be fine.”

“Well, you can die of a benign glioma just the same as we have had patients survive anaplastic gliomas. It's less likely of course, but …”

I glance at Jenny who is looking green and confused.

“I'm sorry, these terms mean nothing to us,” I say.

“No,” Professor Batt agrees. “No, of course they don't.”

“What we need to know really,” Jenny says, finally speaking up, “… in layman's terms … is will I be OK? Or am I going to, you know … What are my chances? Of surviving this?”

“A prognosis is impossible at this stage, and useless at
any
stage,” he says with a sigh. He sounds smug. He sounds like it's one of his favourite catch-phrases.

“Sure. But she's not going to actually … you know …
die
from this is she?”

“I have a daughter to think about,” Jenny says. “A prognosis isn't useless
to me.”

“Let me try to explain …” the professor says. “It really makes no difference if I tell you that you have a one in ten chance of living another thirty years, or, say, a thirty-to-one chance of living another ten.”

“Well it kind of
does,”
Jenny says.

Professor Batt shakes his head slowly. “I'm afraid it doesn't my dear. Because that still doesn't tell you whether you'll be the one-in-ten or one of the other nine. Statistics are population based. But they have little meaning for one specific individual. Prognoses are just statistics and statistics only function for the group.”

Jenny looks at me. “Do you understand this?” she asks.

I blink slowly. “Yeah, kind of,” I say. “He just means that no matter how bad the prognosis you might survive.”

“And no matter how good, you could still be one of the ones who dies,” he says.

I glare at him. I could kill him for that remark.

“Maybe you can explain that on the way home,” Jenny says. Turning to the professor, she continues, “So what happens next? Do I make another appointment?”

“Well, I'm afraid what
doesn't
happen next is a trip home.”

“I'm sorry?”

“I don't think that you're going home my dear. Not tonight. Not if we have a bed available.”

“But … Oh … My daughter.”

“I can sort Sarah out,” I volunteer.

“And I haven't even brought …”

“Your tumour is not a candidate for surgical removal, as I said, because of its position. After discussion with Tim at Saint Bart's, we rather agree that time is of the essence here. If we can get you in
for the biopsy tomorrow and, say, the spect on Thursday or Friday … Yes. That way, if this
is
malignant,” he says, tapping the scan with his middle finger, “we can get you into treatment as soon as possible, maybe even as early as next week. It's up to you of course, but I really wouldn't advise any dilly dallying.”

I turn to look at Jenny. She looks like a Madame Tussaude's figure – pale and waxy. She stares back at me and then for some reason, quietly repeats the words,
“Dilly dallying.”

I hadn't wanted to get Mark involved, but my feelings were in such a maelstrom that I wasn't even sure why. To begin with, I thought I was keeping him away because I knew I couldn't rely on him – he had betrayed me. Big time.

And then I thought I was doing it for
his
sake, because it wasn't fair to dump all of that angst upon him.