My Year Off Page 10

  On the whole, I do not remember my dreams at this time, and despite the extraordinary upheaval in my brain I cannot report any particularly vivid dream activity. If there is an exception to this observation it is that I had several sexual dreams, mostly adolescent fantasies. On several pages in my diary I find now that I’ve written, ‘During my sleep I dreamed of sex once more.’

  SARAH’S DIARY: 20 AUGUST

  R. is beginning to clamour for big, fat non-fiction books, biographies and the like. ‘Narnia’ isn’t doing it for him any more. He enjoyed the nostalgia of The Lion, The Witch and the Wardrobe, but reacted with highbrow indignation to The Magician’s Nephew. These are good signs, I think. Everyone keeps asking me if he is going through personality changes. Quite a scary question, because the truth is I’m not sure: is he impatient and peremptory because of the combination of his normal self (before I came along) and the frustration of his condition, or because of a neurological problem?

  Several visitors wanted to know if I had ‘changed’, a question that often came with enquiries about religion, and even now, two years later, it’s a question I find hard to answer honestly. At one obvious level I have changed significantly; at another I feel myself to be just that: my self. For a while I had a strong fantasy of renewal and regeneration, and for a while it seemed as if I could begin my life again. Now, I know that this is just that, a fantasy, though a powerful one none the less. In one respect, however, I did change. I became less intolerant of difficulty.

  MY DIARY: MONDAY 21 AUGUST

  I have been nearly a month ‘inside’ today. Time has dragged very slowly, but I’m getting used to this slow passage of time, as I am to my situation.

  My thoughts are still of the past, and of the ‘truth’ of the past. In some ways, I realize, this sequestration is parallel to the time I spent alone at school after my operation in nineteen-sixty-whatever it was. One thing that strikes me is that the Faber staff are being incredibly kind to Sarah, and that she and they have become friends, which is really rather nice. One of the great things about Sarah’s having to look after herself in the outside world while I am here is that she meets my friends on her own terms rather than meeting them through me, which is probably a good way of doing things, and a good way for her to establish her own identity in London.

  Last night I watched a programme about punks on the television. This brought back so many memories of first coming to London in the seventies, of living in the North End Road, near the Nashville Rooms, during the best/worst of Sid Vicious and the Sex Pistols. It’s very odd how so much of the past seems to be coming back at the moment, at a time when I have so much time to think about the past and reflect on it all.

  Then, a visit from Adam Phillips [friend and psychoanalyst; author of On Kissing, Tickling and Being Bored], who has a quite brilliant bedside manner, as I suppose he should. We talked about what it means to lose independence, especially for those of us who cultivate the idea of it; what it means to be a patient, and what it means to lie still in a bed for weeks, with no means of walking off our anxieties. Apparently, Adam says, Coleridge writes in his notebooks somewhere that convalescence is the time when we see the world the sharpest. He asked what I was reading, and if I was depressed. We talked about Africa … [illegible] … punishment, and the idea that one deserves bad luck. We left it that I would call him if I wanted to see him, and I made a note to do this. He asked if I felt that I would be forgotten, and I said that I did, occasionally. He asked about my dreams, and I explained that they were often very vivid, but couldn’t at that moment recall any dreams of special interest. Adam recommended reading Oliver Sacks’ An Anthropologist on Mars. Eventually he left, having calmed me down considerably.

  Now it’s lunchtime, and blazing hot outside. The drought continues. I still find myself longing for a nice small war on television. I explained to Adam my obsession with food programmes and the news. Also nature television. I can watch cookery programmes like Ready Steady Cook for hours, and take much pleasure in imagining the taste of the food, a taste that is now denied. I also like watching nature and travel programmes, and luxuriate in the view of the countryside one gets from television. This is another reason for watching Channel Four, which seems to me to be vastly superior to the BBC.

  I’ve come to realize what it means to be an ill person, to be stuck in one place and unable to enjoy the world outside. Adam and I also discussed the way in which most doctors don’t have a clue. He says that if you pay for health care and go on the private side, as I have, they are much more likely to discuss your chances, the prognosis and so forth, than if you go on the NHS, where they won’t tell you a thing. Doctors have their professional pride: because they often don’t know the causes of stroke, and its potential outcome, they refuse to be drawn into a discussion of what’s happened. Doctors have their fantasies of omnipotence, too.

  TUESDAY 22 AUGUST

  Being a patient means having time to think, time to brood. It’s a bit like being a baby again. All you can do while you are lying there is to organize your thoughts and make the most of your time, and of course, being alone in hospital (like prison) is not the same as solitude. There are constant interruptions from nurses and so forth, and there is nothing willed about it at all. You have to submit to the experience.

  Now that I’m scheduled to go to the Devonshire [Hospital] for rehab, I am starting to feel very fond of, 1. the ward, and 2. the nurses. Julia came to say goodbye today, and said that I would soon be walking back in to see her. I’ll certainly miss her, and Hanifa, and Mamie, to whom I have become very attached.

  The press today is obsessed by the drought, which seems to be raging up and down the country. One of the worst things about this illness is that I shall have missed the best summer of my lifetime.

  I have now been here almost a month. The most important thing is to explain the mood from day to day. Today my mood is much better. I saw Emma [my assistant] and Belinda [the managing editor] from Faber’s this morning, and we chatted happily. This morning I had a new physiotherapy session, and the nurse said I would be going to the Devonshire on Friday. I am looking forward to this greatly.

  In the afternoon I had a succession of visits from friends … [illegible] … ending with my dear brother Mark. I felt very cheered up by all these visits. [My friend] A. brought some soup, and cracked jokes, and stayed for ages, and was delightful. There’s no doubt that visitors make a huge difference, and make the time pass more easily, though too many at once can be a strain and not enjoyable. People say you should visit the sick. That’s true, but you should not drive them demented. I can be lonely here, but I also enjoy my solitude.

  There’s also the question of visitors’ etiquette. When do they leave, and how soon? It is up to them to say when they are going to go, but I have developed a way of saying ‘Thank you and goodbye’, as a way of preserving my energy.

  When asked by visitors at this time about my feelings, I liked to pretend to myself that I was taking a well-deserved break from my office, but in truth, when I look back on these days, I remember two kinds of anxiety. The first, which was quite irrational, was that my company would stop paying my salary and that I would not be able to afford to convalesce at leisure. In hindsight it was odd, I suppose, that I should be concerned with money and my bank overdraft when, physically speaking, I was incapable of tearing off a cheque from its stub. The fact is that even in hospital we cannot escape the tyranny of the mundane. Just as death and taxation are said to be always with us, so also are sickness and bill-paying.

  The second worry, which was not answered by any evidence, was that my co-workers were merrily subverting my authority and opinions in my absence. A publishing house expresses a vision. During nearly twenty years I had played a central role in creating, developing and shaping this vision, generally through the books Faber & Faber had published. I became convinced, quite wrongly as it turned out, that everything I’d done was being scattered to the four winds. I was so ashamed of this sel
f-centred anxiety that I could not bring myself to discuss it with anyone, not even with the chairman of the firm, Matthew Evans. It was not that I felt redundant suddenly, more that I had somehow lost control of an organization in which I had believed myself to be indispensable. I have discussed this aspect of my illness with many stroke-sufferers and they almost all confirm having experienced similar feelings of anxiety vis-à-vis the workaday world from which they have been disconnected.

  The other aspect of my incarceration in the Nuffield was that I finally came to understand what the Thatcherism I’d lived through meant in practice. For a decade and a half the country had been privatized and deunionized and monetarized and reorganized and, although I’d followed it in the newspapers, it had made little impact on me personally, except insofar as I was apparently better off (bigger salary, less tax, etc.). Now I could understand the true meaning of a privatized health service: invoices for every treatment, staff shortages, overworked ambulance crews, teams of sharp-suited hospital administrators conducting fatuous management exercises and the desolation of empty wards.

  I lay, staring at the hospital ceiling, trying to remember, as a kind of mental exercise, the names of the writers I’d published these last sixteen years, country by country. Occasionally, I would spend hours checking through this list, staring out at the sky and wondering when I was ever going to be released from the torment of immobilization. Daydreaming was one way to escape; the other was my Red ‘n’ Black notebook.

  MY DIARY: WEDNESDAY 23 AUGUST

  One of the strange things is that when people come through the door, I don’t know for a minute who they are, and it takes a while to remember who it is; sometimes I don’t even recognize them, which is rather peculiar. It’s at moments like these that I wonder if I’m losing my mind. Some days, madness seems just round the corner.

  I find that I am feeling very tearful at the moment, not merely tears of anger, or rage, or depression: I just feel very emotional, and can cry about the smallest thing.

  SARAH’S DIARY: WEDNESDAY 23 AUGUST

  Feeling quite blue and tired today, as if grey stormclouds were everywhere. I’m getting that helpless, hopeless feeling again. I feel as if I’m all alone. I so depend on the last thing I have heard, the last person we have talked to, so that way my moods fly around all the time. If R. is glum and seems unwilling to try, I feel despair. If I talk to someone who says he is making good progress, I feel elated. A neurologist came in the other night and was so dour, so unsmiling, so creepy that it made me want to cry (R. said he was a typical Englishman of a certain sort, and that he could easily handle him). He talked about parameters and profiles, and then said that R.’s left hand would be ‘useless’, which was horrifying to hear. But then he amended it to say that it would be much better than it is now, which to my mind means that it will be better than useless. I felt so angry and scared and indignant on R.’s behalf. I’m sure these doctors have little psychological tricks for what they say. But I’m equally sure that they are uncompassionate, semi-aliens who just don’t know how to deal with actual people. Maybe it’s just too depressing for them giving bad news all the time, maybe it’s easier to look at scans than to talk to patients.

  MY DIARY: THURSDAY 24 AUGUST

  This is my last day in the Nuffield ward. I had physiotherapy at eleven. Tomorrow I shall be going to the Devonshire at two thirty. They have booked an ambulance to take me. Julie Kavanagh [friend, biographer of Frederick Ashton] rang, and we talked about Raymond Blanc’s stroke [from which he made a full recovery], then John Walsh [friend; journalist] rang, wanting to do a diary story in the Independent. I found talking to him very alarming and difficult, and felt very tired afterwards. Speech is very tiring, and I find that my volume is very hard to control. My tongue often feels very heavy in my mouth, despite the therapy from nice Dr Click [Whurr].

  I have developed a concept of the ‘good’ waiting period and the ‘bad’ waiting period. A ‘good’ waiting period is one where you know the outcome, and where you know that you are going to leave when they say you’ll leave, or where you will be doing things when they say you’ll do things, and a ‘bad’ waiting period is when you don’t know what is going to happening, and you are just hanging about.

  Tomorrow I shall have been here four weeks, and in summary I find that I have been amazed by the loving warmth and generosity of my friends and the interest of the outside world, stupefied by the boredom of the routine of the hospital, and the exhaustion of convalescence. The nights are often very difficult. I have become obsessed with the details of mobility, especially the wheelchair operation.

  SARAH’S DIARY: THURSDAY 24 AUGUST

  To the Devonshire rehab tomorrow. I find I get very nervous whenever anything new happens, and this particularly because it’s a change in what has become a sort of refuge, and because it means a whole new round of tests where they evaluate R.’s condition. I’m so afraid of bad news – that they’ll say he’s not going to get much better, that he won’t be able to walk well (or even at all) and won’t be able to use his hand again. Doctors scare me, medical evaluations scare me, new predictions (or non-predictions or people looking sombre and negative and using words like ‘useless’) scare me, the future scares me. R.’s using his leg more, and leaning on his left elbow but still nowhere near walking. People keep telling us stroke stories but it’s still a complete mystery to me at least how he is supposed to walk. Were the strokes in those cases less severe than this one? More? Should more have come back by now? Or does that not matter so much? So much depends upon what happens at the Devonshire, and so I’m trying so hard not to let mine and R.’s expectations become unrealistic. I think R. needs to work and we both need good fortune and patience and perspective.

  Pulling through. R. quite confident, at least to me, because he knows how scared I am. But it’s so tiring, for both of us, and progress is so incremental. I don’t know how much of a long view I need to take. I don’t know what it’s right to hope for – I have to learn how to hope for the best but prepare myself if it doesn’t happen. And so does Robert. He seems sure that it will be okay, but I wonder if he really believes it, and I wonder how realistic he’s being, and I wonder if his hopes, too, are going to be dashed in the end. I pray to a God I don’t believe in. But I had an absurd thought the other day, that the thing about God is that even if you don’t believe in him, he listens to you. Maybe there’s some religion in me after all.

  [9]

  Death and Dying

  August-September, 1995

  We study Health, and we deliberate upon our meats, and drink, and air, and exercises, and we hew, and we polish every stone, that goes to that building; and so our Health is a long and regular work; But in a minute a Canon batters all, overthrows all, demolishes all; a Sickness unprevented for all our diligence, unsuspected for all our curiosity; nay, undeserved, if we consider only disorder, summons us, seizes us, possesses us, destroys us in an instant.

  John Donne, Devotions

  Perhaps not surprisingly, in the aftermath of my stroke I became quite obsessed with death, and with the skull beneath the skin. This perception was enhanced by my everyday encounters as a patient. I discovered then – and throughout my convalescence – that we (and our loved ones) are all unwell. I lost count of the number of times people confided in me either the recent death, or the profound sickness, of someone near to them, or their own close encounter with acute illness. Some people described transient ischemic attacks; several more told me of friends or relatives who’d suffered a recent stroke (or heart-attack) and who had, none the less, gone on to make a complete/partial/rapid/gradual/impressive recovery. In short, my illness was an eye-opener not only to my internal world but to my external one, too. I felt reenfranchized into a world of feeling from which I’d become dissociated.

  So, when I look over my own past now, the figure of Death seems to be standing there at every turn, in one guise or another. Years before my own ‘brush with mortality’, I find that the
theme runs like a dark thread through my imagination. Even when I was at home in England I was irresistibly drawn towards it. (My most recent novel, Suspicion, completed just before I fell ill, is narrated by a county coroner, an expert in untimely death. ‘So often,’ says my fictional alter ego, ‘have I travelled the grim byways of mortality that there was a time when, against my will, I used to think of myself as the angel of death.’) Perhaps this is a family trait. For some years, my mother had been the chair of a hospice in Cambridge. Not long before my first meeting with Sarah, I had spent a day at the hospice with Dr Tim Hunt, the resident doctor and an acknowledged specialist in death and dying. It was a day that came back to me many times during my convalescence, reminding me that, compared to terminal illnesses like cancer, the stroke-patient is, in the words of the Beatles song, getting better every day, better, better, better.

  When I take my mind back to that outing to Cambridge, I see that then I was fascinated by imminent death, fascinated and scared, as those of us who have had little to do with it often are. Now that I’ve had a glimpse of this terrifying figure, an inkling of what it might actually be like to die, and have survived, I find that I no longer have that anxiety, but naturally I long to live. We all do, and the sudden, irretrievable finality of death remains so total, so colossal – a massive black wall, rearing up, tidal wave-like, to engulf us – that it’s hard not to be awed by it, as we should be. ‘Death,’ observed W. H. Auden, ‘is like the rumble of distant thunder at a picnic.’ I have not lost my respect, of course, but I have lost my fear. I have known what it feels like to be carried away, helpless, towards oblivion and finding by great fortune the current slow and swirl towards the bank, leaving me sprawled, quite helpless, on a new shore.