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5

The next morning I returned to the hospital. As the lift rose past the second floor, then the third, I prepared myself mentally for the meeting to come. I had never yet dealt with a patient whose injuries were so severe, or whose diagnosis was as uncertain as that of Patient DL’s. I told myself that she was no different from the rest, only a little further along the spectrum, the scale of handicap, and that therefore I should treat her no differently. Even if she appeared not to respond to my attempts to communicate with her, I should continue to address her in the belief that she understood. I repeated the mantra over and over in my head: she’s no different, she’s no different. But I couldn’t quite drown out the small voice that said, there is something quite unusual about this patient and you know it. The upshot of this internal wrangling was that I was nervous, and several times as the lift rose, wiped the sweaty palms of my hands on the seat of my trousers.

When the doors opened at the fifth floor the first thing that struck me was the silence. It was thick, almost palpable, and when I glanced towards a window, and saw beyond it an overcast sky punctured by a few high-rise buildings, I realised with a shock that I had never set foot on this floor before. I had dealt with patients in hospitals on the other side of the world, but this was the first time I had ventured on to the fifth floor of my own. The fourth floor was where I had conducted most of my business, where the patients were, generally speaking, responsive. The silence was like a challenge to me: is there really anything you can do here? it seemed to say. Aren’t you out of your depth?

I presented myself at the charge nurse’s desk. She gave me a friendly smile and when she spoke her voice seemed to ring out too loudly, though in fact, I realised afterwards, she spoke at a normal volume. She checked her list and informed me that the patient had no visitors at the moment. It was still only eight thirty. Her first visitor of the day would arrive at nine. ‘And who will that be?’ I asked.

‘Her father,’ she replied. ‘He comes every morning and sits with her for an hour. A nice old gentleman. Quiet as a mouse.’

She pointed towards the mouth of a long corridor whose walls had been painted dark green up to waist height and cream above, with a long, narrow, black line separating the two. These were the colours that indicated the public areas of the hospital, though public and private lost their significance on this ward, where the patients were so ill they required round-the-clock care to keep them alive. In keeping with the hospital code, though, there was also blue linoleum underfoot, rather than carpet. The only thing that set this ostensibly public ward apart from the real public wards lower down was that each patient had his or her own room – on lower floors, and along with carpet, the exclusive privilege of private patients who paid for their care.

The corridor stretched off into the further reaches of the wing. I followed it and turned right where it formed a ninetydegree angle, and left where it formed a second. As I moved further away from the nurse’s station and, as it seemed to me, the living heart of the ward, the silence grew thicker still. I’ve never been to a morgue, but I suspect that if I had it would sound something like that. The notices occasionally taped up by the doors might not be worded so differently either. One read: ‘Do not enter without gloves or apron’, another: ‘Latex allergy’. Slowly my ear grew attuned, and I began to detect the sounds of frail, struggling life: the hum and occasional click of life-support machinery. The rhythmic expansion and contraction of twenty diaphragms. The faint, almost inaudible breathing of creatures trapped between life and death.

I found myself making efforts to walk soundlessly, not to let my shoes squeak on the linoleum. Eventually I came to the last room on the corridor. It had no notice pinned up outside it, but the door was open and glancing inside I was struck by the sight of a shiny balloon floating in a yellow haze. A child’s birthday balloon, filled with helium. Semi-deflated now, with the words ‘Happy Birthday!’ looping across it, it bobbed at half mast and a low voice seemed to emanate from it. As I stepped over the threshold, I realised that the voice actually came from a TV suspended on the wall above and behind me. I naturally turned to look at the woman lying in the bed, whose line of vision I had broken, and that’s when I got the fright of my life. Her brown eyes were fixed on me, and in them was a steady gleam of contempt, as if the liquid of her iris had crystallised that way. I froze, and in the instant that our eyes met I half expected her to rear up and point an imperious finger out into the corridor. But her gaze merely slid away from me and became liquid again.

Feeling like a clumsy intruder, my heart hammering against my ribs, I lifted the clipboard out of its slot at the foot of the bed and pretended to peruse the drug chart. My hands were trembling, but I forced myself to focus on the words printed before my eyes. Name: Diane Levy. Date of birth: so-and-so. I peeped over the board. Her head lay in the same place on the pillow, but her gaze was vacant now, and dull. A thread of saliva ran from the corner of her mouth, down over her slack jaw. Breathing a sigh of relief, I glanced quickly around the room.

My first impression had been of entering a shrine or grotto, and now I saw that I wasn’t far wrong. A ledge running at waist height down the side of the room facing the bed was crowded with small objects, ornaments and such like, while the wall above it was densely covered with fragments of drawings, letters and photographs. There were several vases arranged about the room, containing flowers at various stages of freshness. At the windows hung not the usual, pale, waxy hospital curtains, but ones with a flower pattern, white on blue, good cotton and properly lined. They were cheery, the sort you might find in a nursery, and obviously home-made. At the side of the bed nearest the window a rocking chair was covered with a pink, mohair rug that carried the impression of a large person’s shoulders and haunches. On the other side, nearest the door, stood a plain, straight-backed wooden chair that had been pulled up close to the bed, and on this I now sat down.

From her date of birth I calculated that Diane had recently passed her thirty-first birthday. Close up, she looked younger than that. Almost childlike, as if the injury to her brain had also knocked her body’s internal clock, causing it to stop. There were no blemishes on her sallow skin, not a single worry line or crease of laughter. Nothing had troubled that flawless complexion for a decade, except perhaps very fleetingly, and then only a surge in electrical activity, a bubbling over of the animal parts of her nervous system. Her hair, which had been cropped high on her neck, was tousled and shiny as a conker against the snowy-white pillowcase.

I introduced myself and explained why I was there. ‘Soon some men will bring a machine,’ I said, taking care to enunciate clearly. ‘It will arrive in parts. I’ll put them together and then I’ll show you how to use it. Before you know it, you’ll be able to ask for anything you want.’

Somebody was walking in the corridor outside, I heard their footfall and turned quickly. But there was no one there, and when I turned back my heart skipped a beat. Slowly, almost as slowly as Mezzanotte’s brainwave had risen to graze the foot of the letter A, Diane was arching her eyebrows. They fell at the same controlled rate, and her lips stretched horizontally beneath the feeding tube inserted into her nostril. At that moment a light came into her eyes, as if someone had shone a torch through the back of her skull, and her face lit up with a joyous smile. Her lips parted and I saw her small, wet tongue lolling inside. I sucked in my breath. At that moment, as if she had achieved the desired effect, the light went out, and once again her dull gaze slid past me.

It’s a reflex, I told myself, a simple reflex. But what if it wasn’t? On an impulse, I leaned forward and squeezed her bony fist where it lay, immobile on the sheet, to let her know I had seen. It was cool, a little rough to the touch. I saw myself do it; from a point on the ceiling I observed my own rather secretive gesture, and I immediately felt foolish. As I straightened up and let go of her hand, I caught a whiff of something. Not the usual smell of the chronically ill, but something sugary, cloyingly sweet. A wave of nausea rose to my stomach, so powerful it pushed me up to my feet and away from the bed. Mumbling something about another appointment, promising to return soon, I backed out of the room and sped away along the corridor.

The Quick

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