Читать книгу Beyond the High Blue Air - Lu Spinney - Страница 10

I

We have arrived too late. Everything has happened; we are simply witnesses to the aftershock. Charlie and Ben are waiting in the hotel foyer and the two young men, fit and tanned after a week’s snowboarding, are tense, tight-faced with the knowledge of where they are about to take us. They arrived in Innsbruck yesterday evening and were waiting at the hospital for Miles when he came out of the operating theater. Ben says the sight of him then was too difficult to be able to describe it to us; he was glad we had not yet arrived.

I hate that I don’t have those memories. I wish I could see a slow-motion replay of the accident, see his face close up afterwards, know what was going through Miles’s brain as it was splintering—

I cannot bear that it was unshared. I cannot bear the isolation of that moment, the loneliness: I imagine him falling like an abandoned astronaut, no longer tethered, his lifeline floating free as

he sinks through dark galaxies and whirling fragments of comprehension that the world is disappearing far behind him. I wish I could have been there, to hold him and tell him how much I loved him, how much we all love him, how we would fight for him.

Ben and Charlie take us to the hospital. As we walk into the vast glass-and-concrete foyer of Innsbruck University Hospital I feel the air being sucked away from me. The floor rises in waves, the walls bulge in, I can’t breathe; I have to get away. Disembodied, I look down from somewhere high above us all and watch myself talking calmly to Charlie as he leads our small group through the crowd of people towards the elevator, as though this were a perfectly ordinary thing to be doing this sunny morning.

We are sitting in a row in the waiting room, waiting. The room is silent, save for the dull hiss of oxygenated bubbles coming from the glass fish tank in front of us. Inside the tank tiny iridescent fish dart and swoop, up and down, backwards and forwards, their mouths gaping senselessly. The room is small and square, three walls painted a soft sea green and the fourth, adjoining the corridor alongside it, made of thick shatterproof glass. The fish tank sits on a plain black metal table pushed up against the wall and next to it there is a small wooden shelf with water jug, glasses, and a telephone for visitors to announce their arrival. There are some metal chairs, cold to the touch, and the long wooden bench on which we sit as well as a wooden coffee table with brightly colored Austrian magazines on it. At the end of the glass wall is a door with a small silver keypad next to the handle. It cannot be opened from our side without a code; we will have to be let out of this room when the time comes. Occasionally a doctor or a nurse passes by on the other side of the glass wearing cotton trousers and overshirts the same sea green as the walls. I notice they keep their eyes straight ahead, averting their gaze from us.

Only two people at a time can visit the ward, accompanied by a nurse. I go first with Will, down the corridor that we will come to know so well, stopping at the end to take out the plastic aprons and gloves from their dispensers on the walls. Even more disoriented in this new uniform, we then turn the corner to face the ward. It feels as though we have entered an underwater world: tinted green glass divides cubicles and nurses’ stations, and everywhere is silent save for the rhythmic tidal swish of respirators and the soft sonic keening of machines, like whale calls in the deep. Nurses and doctors glide through the rooms, serious, intent on the silent bodies each beached on their high beds.

As we reach Miles’s cubicle the dread of seeing him engulfs me. Will has his arm firmly around me as we enter what is—I sense it at once—a hallowed place, a shrine; there is an overwhelming impression of a warrior, wounded, suffering. Afterwards we discover that we all felt this same thing, felt the sense of spiritual power heavy in the room and that we were on the periphery of something beyond our mortal comprehension, as though Miles were absorbed in a conversation with Life and Death and we should not presume to interrupt.

He lies on his back on a high bed in the center of the room, perfectly still. The stillness is terrible. His strong face, the one we are so familiar with, that we know to be so expressive, humorous, animated, is closed from us in a way it would not be if he were asleep. After a week in the mountain sun his face and neck alone are tanned, a clear demarcation line where the top of his T-shirt would have been. He always tanned easily and it suited his dark looks; now that demarcation line breaks my heart. A sheet has been placed like a loincloth over his middle, but otherwise he is naked, his muscular young man’s chest and arms and beautiful virile legs defying his injury. A multitude of wires and tubes connect his brain and body to the bank of machines and electronic charts behind him which are recording every tremor of his existence, tubes coming out of his nose, his mouth, the top of his head, his chest, his wrist; but his face, bruised down the right side only, is calm, his eyes closed, the violent new scar running serenely from his hairline up and over his partially shaven head and down to the base of his right ear.

He looks so strong, so healthy, in such fine physical condition. How can it be that only his brain is damaged, and quite so damaged? It is later we are told that he is known by the doctors and nurses on the ward as the Athlete; the nurses flirt coyly with the word. But it is not just his body that is powerful; something is radiating directly from him, the air is thick with his presence.

Will and I stand silently, on one side of the bed. On the other a male nurse is filling in a chart. He finishes and turns to us, apologizes for intruding at this moment but explains that because Miles is on a ventilator there must be a qualified person in the room at all times. His English is impeccable. A ventilator: I wonder what the word for it is in German. In whatever language it is a thing only ever glossed over, half imagined, in a fleeting glimpse of horror. An iron lung it was called when I was a girl and polio was the scourge of the age. I remember my childish incomprehension, seeing pictures of people encased in them, as though they were in an iron suitcase like a magician’s accomplice, and the shock when told they could not breathe without it.

There is too much to take in. I bend down and kiss Miles’s cheek, then the other cheek, his forehead, his nose, his neck, his chest, but it’s no good, there are too many tubes in the way. I begin to speak, hesitantly, it seems difficult. We love you so very much, Miles. You know that. We adore you, we absolutely adore you. You know, don’t you, that we are all here for you. We can feel your strong fighting spirit, you are with us as you always are. You will be all right, you’re going to be all right, you are going to come back to us. I love you so very, very much, my extraordinary, precious, beloved son.

Who cares if I am gushing. Will bends to kiss Miles too. You’re going to make it, dude, he says quietly, you’ll be back. I love you, Miles. How gentle he is, this other precious son of mine, his gentleness intrinsic to his strength.

I need to ask the nurse some questions. The tube inserted into the top of his head, so dreadful to see, is monitoring the pressure in his brain and draining away the excess fluid to reduce the swelling. The tube in his mouth is intubation into the lungs from the ventilator; the one in his nose is intubation to his stomach from a bag of liquid food hanging on a hooked stand above his head. There are more tubes, for hydration, medication, monitoring the heart, a catheter draining dark yellow urine into a bag. The machines recording Miles’s new state of limbo could be the controls of a spaceship, the flickering lines and lights on screens recording his dislocated journey into the future.

The first time I cry is in the bend of the corridor on the way back to the waiting room, out of sight of the ward. Crying in a way I don’t know about, with great racked gasps. Will’s arms are around me and I feel selfish; he must be feeling this too, it is his brother he has just seen, his closest friend and companion, but he is comforting me. We return to the waiting room and I’m conscious of composing myself to face the others, our eyes meeting first through the glass wall as they search our faces for information in a way that will become our twice-daily routine over the coming weeks. Holding hands, Claudia and Marina are now led by the nurse down the corridor to see their brother.

***

Tuesday morning, the second day. As I walk past the nurses’ station a young doctor comes forward and asks me if I am Miles’s mother. He hands me a copy of a letter received by fax that morning and tells me that the doctors and nurses have been reading it.

For the attention of the Family of Miles Kemp

We are thinking of Miles at this very tough time and wishing him the very speediest of recoveries.

Miles has been playing a critical role in one of the BBC’s most important projects. Throughout he has shown an intelligence, professionalism, commitment and charm.

Please let me know if there is anything we can do for Miles or yourselves at this time.

John Smith

Chief Executive, BBC Worldwide

I can’t control my tears. The letter gives Miles substance, a background, the importance of which we are only beginning to learn. In each new institution to which he will be admitted in the months to come he will simply be another TBI, another Traumatic Brain Injury. He’ll have no history, no personality; all that defines him will be his sex, his age, and his injury. The medical staff cannot know that he is thoughtful, funny, brave, kind, impatient, and irascible. They can have no idea about his lived life, its failures and achievements, the way his energy and presence seem to contain some electrical force. The only story they will have in the notes that accompany him is that he once snowboarded, not that he likes boxing and playing poker, writing poetry and playing the fool.

Turning into Miles’s room now, the shock of seeing him wired up and motionless on the bed makes a mockery of the letter in my hand. It was only ten days ago in the cosy sitting room at home with the fire lit and a glass of our favorite Rioja that we had a long discussion about his work and his plans for the future. After putting his fledgling company, K Tech, on ice two years ago he joined an international firm of management consultants and it was from there that he presented and won the account for them with the BBC. He had begun working at the BBC only a few months ago; he would be proud of this letter. Pulling up a chair next to his bed I read it aloud to him, and then I read it again, hopelessly searching his face for a reaction. Of course there is nothing, the softly flashing lights and the undulating lines on the screens above his bed the only proof that he is alive. He is there but not there, though a little part of me is certain he is listening and hearing me. I must hold on to this, my hope is tethered to it, a fragile skein of hope.

At the end of the morning visit we have our first appointment to meet Miles’s doctors. We are back in the waiting room, waiting in silence, for fear that if we speak our dread will spill out. The fish continue to swim in their tank, the overhead strip light glares relentlessly. This room feels like an antechamber to horror, the air heavy with the distilled fear of all the people who have waited here before us.

I need to clear my mind for this meeting, but it’s a scrambled mess of unfinished thoughts that keep sliding away, of questions I can’t frame. With grim relief I see through the glass wall two men in green surgical uniforms walking towards us. Neither is what I expected of a neurosurgeon, the older man with his ruddy jovial face and thick blond mustache, the younger man tall, tanned and athletic-looking, both more like men with outdoor pursuits than doctors. I suppose this is the Alps, I think, but Miles’s life is in their hands; I need to believe in them. When the older man introduces himself his voice is calm, authoritative, his expression no longer jovial as he looks around at each of us, one by one, taking us in. I am Dr. Stizer, he says. I operated on Miles on Sunday evening. He had suffered a severe brain injury and was unconscious on arrival here. We removed a large piece of bone from his skull to relieve the pressure on his brain. He is now in an induced coma and breathing by means of a ventilator. We do not know at this stage what the outcome will be. He lifts his eyes to the ceiling and raises his arms, hands upturned, a gesture of supplication. It is in God’s hands, that gesture seems to say, and I think I don’t want it to be in God’s hands, look what’s already happened in God’s hands. He looks searchingly around at us once more and his expression is so concerned, so kind, that I can see he cares about the young man who is his new patient and he cares, too, about us. I understand the shock you are feeling, he says quietly. We will do our best for Miles. But now, please ask me any questions you may have.

Dr. Stizer is a good man. But what questions? All that matters is, will Miles live? He cannot answer that.

Leaving the hospital together we walk in silence, each isolated in our need to comprehend what has happened. Below us the river Inn flows busily, people stroll past or sit at pavement cafés chatting in the sunshine, the mountains continue to sparkle under a cloudless Alpine sky. The serenity is monstrous. Claudia starts to walk fiercely ahead of us, then stops and turns to me, her face wet with tears: I’m going to take the cable car up the mountain, I need to be on my own. I’ll be back. She turns off to cross a bridge and disappears from sight. I look at Marina and her eyes are wide with pain as she says she will take a walk along the riverbank, giving me a quick kiss goodbye as she descends the steps leading down to the water’s edge.

We all need to be on our own. The information just delivered to us by the two surgeons has become a broken jigsaw of meaning, splintered pieces that need to be reassembled somewhere, alone, in peace. Three of us are left behind standing on the edge of a bridge that leads into the cobbled streets of Innsbruck Old Town and I can see sunshine warming the ancient stone buildings. It looks peaceful; I want to go there. I turn to Will and he understands. He and his father will go back to the hotel and get some lunch.

I have no plan. I probably should have lunch, but I’m not hungry. The world has been put on hold and I’m drifting out beyond the edges. The aimlessness is soothing, a kind of willed deferral of all the jagged thoughts; I will face them, but for now I want to keep drifting. Across the bridge the scene looks comfortingly unreal: delicately ornate façades of buildings in the traditional Tyrolean style suggest a make-believe world far from the morning’s reality. A sign hanging from one of the buildings draws my attention: “Goldener Adler” is inscribed in Gothic lettering and soon I find myself standing outside an old stone inn on the edge of a cobbled plaza. Entering the dim interior I see a chubby young woman at the reception desk who could be Heidi; her dirndl and shining golden plaits speak of mountain peaks and sunny pastures and innocence uncontaminated by pain. Can I help you? she says, and I hear myself replying that I need a room, some rooms. For which date, and for how many nights? she asks efficiently. I don’t know, I answer. Indefinitely. She looks at me with concern. My son is in the hospital. I didn’t want to say that, I haven’t had to say it until now; it feels too private. She takes a key from the board behind her and says with such kindness I must fight back my tears, I hope you will be happy here. I think I have a room you will like.

She does. A corner room that looks out over the plaza, large windows on each wall and a sitting area with sofa, armchair, and desk, it is spacious and light. We could retreat here. The station hotel Ben and Charlie booked us into is perfectly suitable, closer to the hospital and with more amenities, but it is deadening. A businessman’s hotel, its airless decor and efficiency leave nowhere in which to hide away and make private. I hadn’t thought it out until this moment, but some primitive maternal instinct warns me that we could not hold ourselves together for long in such a place, and here we might. How ancient is this instinct to provide a refuge, a burrow, a nest, anything hidden away and safe from the dangers that lurk prowling and snarling in the dark outside? Stepping out of the Goldener Adler into the chill afternoon air I have a sense of having restored a kind of order, exerted some small control over the calamitous events that have overtaken us. Goldener Adler, golden eagle: light, strength. Miles would like that.

Early that Tuesday evening Ron arrives from London. I have missed him; we’ve spoken on the phone but it is his presence I need. Now he is flying out to see Miles, and to see me. Watching him walk across the airport arrivals hall I think again how distinguished he looks, his integrity so obvious that it gives him his particular gravitas, but to know him is to know the ridiculous fun one can have in his company. When we meet I see the pain reflected in his eyes, complicated by his concern both for Miles and for me. How have you been? he says. How is the boy? He takes me in his arms and I feel stilted, different, I’m not the same as before; I am damaged. He was widowed two years before he met me when his wife died of cancer after many years of illness; theirs had been a long and stable marriage and for him and his two now adult daughters, Belinda and Amelia, it was a deeply painful time. I wish he did not have to suffer again on our behalf.

Ron had waited these two days before coming here out of respect for David, that at such a time it should be Miles’s father who sees Miles first with all of us together, the original family. Such consideration is typical of him, though I know Miles would want him here from the beginning. All four children love Ron as a father as well as a friend and confidant; he is an integral part of our family now. David and I separated eight years ago and our lives have settled into their different ways. To be suddenly thrown together again is an unnatural and painful accretion to an already painful situation. To any curious fellow guests on the first morning before Ron arrives we look like just another family on holiday, father, mother, and children sharing a hotel breakfast and later setting off together for a walk through the town; that our group is anomalous and our walk leads to an intensive care unit does not show. The strangeness, the strain for us all, is subsumed by the horror of the situation that has brought us together and when in the evening

the exuberant waiter in the Italian restaurant greets us as la bella famiglia inglese we don’t put him straight. I worry that it is especially difficult for the children, but now Ron has arrived and I take comfort from the civility of his and David’s relationship.

Ron and I take the airport bus into town and arrive at the hotel just in time to join the children and David setting off for the evening visit to the hospital. I can see the children’s relief at his arrival, the sharing of our predicament, his understanding without explanation. Once at the hospital Ron and I go first, walking down the dreaded corridor before I show him where to put on his plastic apron and gloves and then leading him through the eerie silence of the ward to Miles’s room. The machines are blinking, the ventilator soughs rhythmically, the nurse sits quietly in the corner reading. Miles lies alone on the high bed, so still he could be embalmed, a magnificent specimen of young manhood on display for whoever dares. Miles darling, Ron is here. Why do I say that? It’s not for me to be the interpreter, their relationship so strong my intervention is not required. I wonder if Ron would prefer to be on his own with him; it is difficult finding the words, easier to be alone, I think. I kiss them both and leave the room.

The uncomprehending, raw pain on Ron’s face when I return, this strong man rendered defenseless. I put my arms around him and we stand together in silence by Miles’s bed. The nurse turns away and inspects the medical chart hanging behind her.

Embracing Ron, I think, I want Miles to be in love again, make love again.

A week passes. Ron, Will, and David have gone back to London, to work, but they will continue to come and go. Still at university and now on their Easter vacation, Claudia and Marina have remained here with me. We visit Miles twice daily and are beginning to build our days into a routine. But this morning we must face our new reality afresh: the doctors are going to take Miles off his ventilator. They will “wean” him off it—that is the medical terminology.

The word wean is a singular euphemism here, though correct in its way. Miles has suffered a traumatic brain injury and, reduced to infantile dependency by the injury, he must now go through the hoops of developmental stages that are set out unconditionally in its wake. In the way that anxious new parents do, we follow the stages of his development intently and applaud each tiny sign of progress as though it were being achieved by a prodigy. The irony is not lost on us—Miles invariably succeeded, and when something wasn’t easy he set his cap at it with unstoppable determination. How the tables have turned; determination is no longer available to him. The stakes are different: if he succeeds today he will breathe on his own; or he won’t.

Our time with him is spent urgently, the three of us spurring him on in turn, goading him to success. Miles, we say, bending close to his ear, you have been breathing with the help of a ventilator for the past ten days since your accident. Today the doctors are going to take you off it—this is such a strong sign of your recovery. You are amazing, Miles. You are going to come back to us. You can do it, you can always do anything. You have so much life left to live, Miles, you must come back. You want to achieve great things and you will, you know that. You are so precious to us, we love you so very much . . . And so on, the urgency, once again, dissolving into an unabashed gush of feeling.

The afternoon shuts down; if I close my eyes I think I can feel the world rotating. When we finally arrive at the waiting room that evening and I pick up the phone to let the nurses’ station know we are there, time stops altogether for that moment. And then within seconds it seems Dr. Stizer is walking down the corridor towards us and he is smiling, a huge beaming smile under his great mustache. The girls and I are gripping each other’s hands so tightly mine hurts but yes, he unlocks the door and says to me, Your son is breathing on his own! He looks so genuinely happy and now with this kind foreign neurosurgeon in the little room we hug one another and hug him too and dance about like small children, crying the first and only tears of joy that we will know for Miles. He is alive! Breathing all by himself! The amazing boy! We can picture his recovery, we’re euphoric. It feels as though Miles has won the most difficult race ever run, against the greatest odds.

We go out that evening to a Mexican bar we’ve come across that does excellent cocktails. We call the family and all the close friends to tell them the news and many mojitos later we dance down the street to the hotel, chanting as we go: He’s-brea-thing-on-his-own! He’s-brea-thing-on-his-own!

***

Our euphoria is short-lived. The days sink back into their routine; each morning I wake in the hotel room with a stab of fear. I remember what it felt like to wake slowly and easily but now I am taut with foreboding at what the day might hold. I get up and fill the small hotel kettle to make tea for whoever is with me, either Ron or one of the children if Ron’s not there.

Marina is with me today. She has just turned twenty, the youngest in the family and Miles’s adored little sister. Looking at her small shape still asleep in the bed I am relieved to see her face peaceful for the moment. I switch on the kettle and sit down to wait for it to boil, leaning back in the armchair with my eyes closed. Miles is lying in a hospital bed just a few streets away from us; despite breathing on his own he is still in a coma. In the quiet of these cold mornings I have a new ritual: I go to him. I’ve never been able to meditate but this thing I can do, willing my mind to cut loose so that I can join him where he is. There is a list I repeat like a mantra when I reach him: please let him open his eyes and know us, please let him walk again, talk again, please, please let his brain heal so that he can come back and be the vital person he was. I want to use the concentrated force of furious love to make these things happen. I suppose this is the way that some people find prayer helpful; perhaps this is a prayer.

I wake Marina with a cup of tea and call Claudia, who is in the next door room, to join us before we go down to breakfast.

Breakfast has become an ordeal. I used to love hotel breakfasts like a childish treat, the anticipation of what new and exotic choice might be on offer in a foreign dining room, but now I find I can’t eat anything. Walking into this Alpine dining room each morning I am repulsed at the sight of the serving tables set out with what seems a lavishly obscene spread of food: great bowls of gelatinous yogurt, muesli glistening with nuts and seeds, glass jars of dark sticky honey and blood-colored jams, fresh red raspberry, strawberry, dark blue fruits of the forest. There are platters of fat yellow cheeses or oozing creamy ones, slices of violent pink ham and salami, bowls of bald expressionless eggs and baskets piled high with voluptuous rolls. Around these tables the hotel guests circle intently, eyeing the food and jostling for position to load their plates, and I can only think of snouts and troughs. I find a table in the corner and sit down, and around me I’m aware of munching and swilling, a lifting of spoons and forks and cups to mouths that seem to open and close and chomp in a syncopated rhythm of mastication, all in time to the sickening jingle of hotel muzak playing on a loop in the background; it’s like being in an orchestrated farmyard. I am trapped in a nightmare that has continued into the morning, a ludicrous object of grief crouched in the corner, pinched and thin and angry, hollow-eyed and foul.

It is a new thing, this anger, and it is taking unattractive and unexpected forms. It is mostly scattergun, undirected—above all I could machine-gun the moon and stars, but I also want to pepper with bullets anybody or anything that comes in the way of my private grief or, and especially, that may be a threat to Miles. For example, the nurse who seemed careless when taking his obs yesterday or the arrogant young doctor who told me that snowboarding with a crash helmet causes more damage than doing it without one. Incomprehension is generating the anger I feel, we all feel—it is impossible to make sense of what has happened to Miles and our ignorance fuels resentment.

When the girls have eaten and I have drunk my coffee we escape upstairs to the privacy of our room, to think about the day. It will revolve around our visits to Miles, but visiting hours for the intensive care unit are strictly regulated. Two hours are allowed in the middle of the day, from twelve to two, and two again in the evening, from six to eight. We have some time to kill after breakfast and the girls try to study while I try to read. But reading eludes me now. I’ve lost the desire, the private pleasure; now when I pick a book up it feels flat, empty, extraneous. Fiction is impossible, as though my imagination has been depleted trying to comprehend my own story. The most I can manage is a newspaper, but even that is difficult; more than ever the papers seem filled with stories of disasters and tragedies. Miles’s situation has opened a door onto the relentless, unstoppable suffering of other people, every day, everywhere; I feel viscerally aware that this terrible thing that has happened to him is only one drop in a vast cauldron of human suffering. Yesterday I read of a little girl at a fair nearby in Germany, who somehow got tangled in a giant helium balloon that broke its moorings. She was lifted up and away in front of her parents’ eyes, her torn and battered body eventually recovered some kilometers away where the balloon had come to rest in a tree. How could you make sense of that? I feel an incoherent gathering of rage at the pain that has been endured by human beings since time began and that will continue, unabated and unresolved. Which god should be held accountable for this?

We all give up and go for a walk instead. Innsbruck is a gentle town and out on the quiet streets there is no visible pain. No homeless people, or indeed any sign of poverty, nobody who looks unwashed or distressed or intimidating, none of the enervated faces of big city life. The mountain air is healthy, the scenery from every angle calmly splendid, the streets and parks are clean and unhurried. Do we spoil the atmosphere, with our grief? But nobody would know if they looked at us; only rarely do we let our true feelings spill out in public, for that is not our way. I think about TV footage of men and women wailing and gesticulating with grief in the countries where this is their cultural norm and wonder if that helps them to bear the pain more easily.

Just before noon the girls and I turn the final corner of our walk and see the hospital once more like a glass fortress at the end of the street. We each feel the same tightening dread as we catch that first glimpse, the dread accompanied by a sudden surge of fearful hope—something may have happened overnight that we don’t know about yet. We enter the hospital atrium and cross the light-filled space to the far corner where the elevator will take us up to the seventh floor, to Miles.

Yesterday, though, the grief did spill. Marina and I had been out for a walk and passing a small church in a side street we entered it, in the hope that the place might lend us some peace.

After the glare of bright sunshine outside, the dim interior was instantly soothing, the air cool and fragrant with the scent from massed white lilies that gleamed from the chancel. It was empty and as the doors shut behind us a deep silence fell. Marina walked on along the aisle and I sat down in a pew at the back, to succumb to the silence and let the hope and faith of others with which the place was imbued envelop me. But as my eyes accustomed to the pale light coming through the high stained-glass windows and I looked across the rows of wooden pews, all I could see was the giant figure looming up above the bank of lilies at the far end. There he was, a beautiful young man, muscular limbs draped in a white cloth, hands and feet nailed through and coated in blood while his face looked down at me with an expression ghastly in its passive suffering. Instead of peace I felt a fury rising, I wanted to rage at the faith that allowed and venerated such a grotesquery. And then I began to hear a sound like the whimpering of an animal in distress, becoming louder and louder until it rose to a crescendo, an anguished howling of pain that reverberated round the once silent space. It was Marina, braced against the altar rail, her clear young face uplifted and fiercely streaming with tears.

We sat for a long time together at the front of the church. There could be no consoling, no words that could change the situation. We had already learned that comfort came from sharing the pain and waiting until its eruption had passed. When we emerged into the street some time later it was over, and we were just another mother and daughter out on a walk in the beautiful spring sunshine.

I need to write and thank all the friends who have sent letters, cards, flowers to Miles and to us as a family. Grateful as I am, I can’t find what it takes to write individual replies. So I compose a one-for-all response.

Thank you for your wonderful supportive letter/card to Miles/me/us. It is a great comfort to know that you are thinking of Miles in the way that you do.

There is so much and nothing to say. Miles is still in a coma and we wait. There is no respite from the anguish of waiting but he looks so strong and beautiful and seems so close that we feel very positive about his recovery. We just can’t wait to have him back with us again.

That feels too close to the brink. For safety’s sake I need to retreat:

Innsbruck is ridiculously pretty and it snowed right down to the town last night, pure white from mountain tip to cobbled street. I wish Miles were awake to share the strangeness of it. The linguistic delights (kieboschstrasse, crapfencake), the delicate iced cake buildings and jolly Tyrolean men with their feathered hats and lederhosen, the elegant café where a Nazi flag hangs proud above a meeting of bland young people and no one seems to notice (we complained and left, to their surprise), the pride, cleanliness and good manners of everyone, the comfortable conformity. Not one eccentric or homeless person to be seen—everybody looks healthy. Occasionally at night we hear drunken revellers but all they do is sing or yodel happily.

I’ve retreated behind some kind of glib façade. The truth is, I don’t want to share the truth. I’m not ready yet.

I’m worried about the children. Claudia is completing her MA in London, Marina is in her second year at Oxford, and Will travels backwards and forwards from London in the midst of trying to set up his design company. Their lives have been disrupted in a catastrophic way, disrupted but now in stasis. No one knows what will happen next, but we all want to be here with Miles when it happens. The future is held in abeyance.

The four children make up a unit. The boys seventeen months apart, first Miles then Will, a gap of five years and then Claudia and Marina, two and a half years apart. Together they are vibrant, warm, humorous, necessary; various, but one. It has been a constant marvel to me to watch them, know them, see how small frictions are resolved, the weight of their different personalities kept in balance. Now the balance has been upended. Miles, a heavyweight, is missing and the remaining three are having to realign the unit while united in their grief and their absolute commitment to him.

It’s impossible to say whom it affects most. Will perhaps in the physical sense, because he has suddenly lost his lifelong companion. So close in age, attending the same schools one year apart and the same university, sharing many of the same interests and now sharing a flat, they are the best of friends despite their different characters. Miles is defined by his energy, vitality, determination, ambition; he is a natural leader. Will is equally strong-minded, but is happy to follow his own path alone, having no interest in shaping other people’s lives. They share a similar intellect, but whereas Miles is a driver of ideas, Will is privately creative.

The girls’ loss is different but as profound. Miles has been both their eldest brother, a self-appointed protector, and a friend and advisor, someone to have fun with and confide in. I see him now aged fifteen, an aspiringly tough, cool teenager, awful peroxided hair, standing at the kitchen window waiting nervously for the girls to return. They’d been allowed to walk on their own down to the shops at the bottom of our quiet residential road and Miles is reprimanding me. They’re too young, Mum, you shouldn’t have let them go down on their own. I’m going to go and find them. No, Miles, you must not, I tell him. You of all people! He laughs with me, acknowledging the double standards of an independent, experimental elder sibling not countenancing it in the younger.

As the girls grew up and the age gap between them and the

boys became less pronounced, their relationships consolidated into the unit they have become. Now that all four are in their twenties their interests and many of their friends have converged, but Miles remains a powerful older brother and his absence has made a rift in

their lives. Each one is in the middle of a defining process—

university, setting up a business—that will suffer from being disrupted. The emotional impact of Miles’s accident has been traumatic; we must not allow it to damage them practically as well.

Ron is in Innsbruck for the weekend and we talk about it together and with the children. Decisions are made. Claudia will return to London and ask to have her MA exams deferred from May to September, when rewrites are undertaken, so it should be a possibility. I will write to Marina’s tutor at Oxford and explain the situation to him; the pastoral care there is excellent, I know. Will’s situation is more complex, though in some ways easier; his time is not proscribed by terms and exams but by personal deadlines as his future career begins to take off. His business partner is understanding, but undoubtedly combining his work and being here for Miles is going to be a problem.

Traumatic brain injury is by definition sudden and unexpected. Shock and grief follow in its wake, but it is the unknownness, the complete lack of knowledge that compounds the horror. There is no known trajectory to illuminate the terrible blank thing one faces. Somebody you love is there but no longer there. Lack of consciousness is not comprehensible; the person looks the same and that is all. As a family we are adrift together in our ignorance and our craving for knowledge.

I have been talking to the athletic young neurosurgeon on the ward who is the same age as Miles and who, it transpires, is also a keen snowboarder. He is the one who tells me that he never wears a crash helmet when he snowboards. They may protect the skull, he says, the helmet will take the impact, but the sudden acceleration and deceleration can cause the brain to rotate within the skull. I don’t want to hear this. Rotate—Miles’s brain rotated? He continues, The medical term is diffuse axonal injury, or DAI for short. If that happens we do not yet know any way of reversing it.

I research DAI. Please let Miles not have suffered DAI. If he has, his brain will have sheared when he fell, or more precisely, the axons will have sheared. I learn that each of the billions of neurons, the nerve cells in the brain, has an axon, a long fiber that acts like a fiber-optic cable transmitting electrical impulses away from it, allowing one neuron to communicate with another. If the axons are broken, the messaging system is broken. Apparently the brain is made up of tissues that vary in density and during that dreadful rotation the different tissues slide over one another, stretching and shearing the axons that connect them; they cascade. The words are surreal, beautiful: rotate, shear, cascade; it is a betrayal of language. The particular cruelty of DAI is that the areas of the brain stem involved with basic life functions, the cardiac and respiratory systems, may remain unaffected; the victim does not die but is left suspended between life and death. I read that 90 percent of people with DAI remain in a persistent vegetative state. Very few of the 10 percent who regain consciousness will return to near-normal neurological function, and of those who do, the improvement will have to take place within the first twelve months after injury. If there has been no progress by then the prognosis is bleak. It is only after a year from the time of the accident that a neurologist will be able to make a prognosis and even then it will be approximate; the brain does not yield its secrets easily.

Miles, do you remember my last words to you as you were leaving the house? Please don’t do any dangerous jumps, my darling! It was my foolish, ritual request, a kind of game we played. I loved your daring and you enjoyed my mock protectiveness (although it wasn’t really mock, I meant it but I had to say it lightly). I remember you hugged me with that crushing bear hug I love so much and you said, Don’t worry, Ma, I’m older now. I promise I’ll be responsible.

Miles bought his crash helmet that morning just before the jump. He would have died instantly without it. But perhaps without it he wouldn’t have gone as fast, perhaps he would have been more cautious, perhaps it disoriented him.

Is it my fault he bought the helmet?

***

I come across Dr. Stizer on the ward one day. He is in his scrubs, seeing his patients in a break from surgery. It’s strange, he says, but I have connected with your son in a way I haven’t done with a patient before. He could be my son. My greatest hope is that he will return here one day to speak to me himself.

I am profoundly touched by his words and we are both quiet for a moment. Then he says, May I give you some advice? Of course, I say. You saved my son’s life! He looks at me quizzically. The first thing, he says, is that you must never reprimand him for doing that jump. It was a brave and wonderful thing to do. He is a young man and young men should all go out and grab life in the way he did. The second thing is that you should never feel guilty. It concerns me, he says, to see that you and your children come every day to visit Miles. I think it may be too much for you. You must not feel guilty if you go away and enjoy yourselves.

This is a surprise. Neither thing has occurred to me; certainly I would not reprimand Miles for doing that jump. As for feeling guilty, what I do feel is more complicated, not guilt but something stranger, whereby all physical and sensual enjoyment—eating, drinking, long hot baths, music, shopping, reading, making love, laughing—is shot through with a new awareness. It can no longer be simple untainted pleasure. Everywhere I go, everything I do, is suffused with, contaminated by, the image of Miles lying unconscious in his hospital room. The incomprehension at his plight has destabilized me; nothing makes its usual sense, nothing at all. Drinking a cup of tea reminds me he can’t drink; seeing the sun set over the pale mountain peaks reminds me he can’t see it.

Dr. Stizer is an unusual man and I am moved by his evident concern for Miles, on a personal level. Miles would like him, they would get on very well—I can imagine their mutual respect and the laughter their shared rumbustious humor would generate. A fifty-year-old neurosurgeon who snowboards and plays in an amateur rock band in his spare time—they could have a great time together.

For the first two weeks Miles remained in an induced coma; with a controlled dose of barbiturates, his brain had been artificially shut down to the baseline of function. By the time he had arrived at the hospital the right side of his face and neck were grotesquely swollen as the cerebral fluid found its only escape route out of the confines of the skull. When a brain is injured it swells and there is no space for it to swell to; the skull protects the brain but now the protector has become the instrument of destruction. As the swollen brain is compressed against the hard, bony helmet of the head, delicate brain tissue is being damaged in the process. If appropriate, the neurosurgeon will perform a craniotomy as they did on Miles, in which a “flap” of bone rather like a trapdoor is removed to make room for the swollen brain. Then, by inducing a coma, barbiturates will slow down the cerebral blood flow and the metabolic rate of brain tissue and so the blood vessels begin to narrow, allowing the swelling to decrease. The outcome for each person sustaining a brain injury will vary depending on the extent of the original trauma to the brain and, crucially, the time taken to reach a neurosurgeon and therefore the time the brain has to swell unattended. In Miles’s case he had to get from where he had fallen, 2,000 meters high up on an Alpine mountainside, to a neurosurgery clinic 100 kilometers away. That journey took three hours and even the best efforts of a helicopter rescue team could not prevent secondary cerebral damage. There had been nowhere else his brain could swell to except against the skull or down into his brain stem. I have Miles’s case history on admission to Innsbruck University Hospital in front of me. In a crude translation from the German it states the bald facts, as reported by the paramedics who attended to him on the ski slope and accompanied him in the rescue helicopter to the hospital:

State of conscious: unconscious

Breathing was still spontaneous, but he had an apnea soon

Ventilation with a mask was started immediately

Motor reaction: no reaction

Eye opening: no reaction

Verbal reasoning: no reaction

Pupil reaction: left, no reaction, wide

right, no reaction, wide

During transport they got unequal

Intubation was necessary immediately

Grade of injury: life-threatening

GCS: 3

GCS, the Glasgow Coma Scale. It would become our cruel yardstick, our unyielding beacon of hope, Miles’s new star grading. First published in 1974 by two professors, Graham Teasdale and Bryan Jennett of the University of Glasgow’s Institute of Neurological Sciences, it was devised as an attempt to put in place a reliable method of assessing levels of consciousness after brain injury. The scale is divided into three parts, E, M, and V—Eye Opening, Best Motor Response, and Best Verbal Response—15 points being the highest score and 3 the lowest.

Miles is rated 3. The minimal response a human being can have to life. What does that actually mean? What is happening in Miles’s head? Can he dream? Can he feel pain? Can he think? How different would he be with a score of 4?

A year ago Miles crashed and wrote off his motorbike. I still have the London Hospital discharge report:

Motorcyclist in RTA. Head on collision. Car at 35 mph, motorcyclist at 20 mph. Over handle bars and rolled off bonnet. No loss of consciousness. Remembers entire event. GCS 15 throughout. Patient discharged home with crutches.

GCS 15 throughout. That meant nothing to me at the time. How impatient and irritable he was, being on crutches. Instead of merely injuring his right leg as he did, I wish now that he had broken every bone in both his legs, crippled himself so completely he could never have snowboarded again.

Every day, morning and evening, we walk from our hotel to the hospital. We turn the final corner and there it looms, snowy mountains and serene blue sky unnervingly reflected on the elegant glass frontage. When we reach the seventh floor and I lift the phone to request admittance, I am as tense as if I were alone in a dark house and think I can hear an intruder: fear mixed with the hope that I may have imagined the danger, every nerve on full alert for this thing that is out there, unseen, unknown.

Claudia and Marina are with me this morning. Since the girls and I visit Miles every day the staff have waived the two-visitor rule, and as the three of us walk towards his room our combined fear and hope become tangible: dread that his incomprehensible stillness will be the same, nothing will have changed; hope that he will have woken from his coma, that the nightmare will be over. Dread and hope and incomprehension; it is the same every time. We turn in to his room and today something is different: Miles, inert, unconscious, still connected by multiple wires to those monstrous banks of machines behind him, has been strapped to his bed. The straps are thick brown leather, as I imagine the straps of a straitjacket must be, and they have been passed twice around his wrist and tied firmly to the metal rails each side of the bed. It is like unwittingly entering a room in preparation for torture. Pictures flash up in my mind, illustrations I have seen somewhere, Goya-esque sketches showing in finely etched detail the inmates of a madhouse cruelly restrained, shackled to great iron rings on the walls. What on earth is going on? I demand of the nurse on duty. Who did this? What has happened, what did Miles do that this is necessary? Oh, please don’t worry, she says, this is normal. The doctors are planning to bring Miles out of the induced coma today and we often find that when patients are coming around they try to pull out their drips and feeding tubes. The straps are there for his protection.

After two weeks Miles is being brought out of his coma. This is momentous news. I wish they had prepared us; it seems a far greater test than his being taken off the ventilator. We no longer fear for his survival, but we have not yet addressed what comes next.

Dr. Stizer arrives but before I can say anything he apologizes. I’m so sorry, he says, I wanted to see you before you came to Miles but I was called away. You must be upset to see those, he says as he looks at the wrist straps, but I wanted you to know it is somehow good news.

His English is not perfect, but his kindness is all that matters.

We can see on the scan, he says, that the swelling on Miles’s brain is coming down and it is better not to stay too long like this. He gestures towards the screens and monitors behind Miles.

We want our boy to wake up! Dr. Stizer smiles at me then, but the smile fades quickly as he speaks again, now serious. We do not know how he will be. We have to do this thing very slowly. Claudia and Marina are next to me and he looks at us all as he says carefully, You must go away and you must not worry. We are taking care of him.

What Dr. Stizer does not know is the extraordinary rising, surging wave of hope that we cannot keep down for now; it has drowned out any worry we might possibly feel. When he leaves the room I tell the nurse that at all costs, no matter what time it is, even if it is the middle of the night, the nurse on duty must call me to tell me as soon as Miles begins to wake up. We will come to the hospital. I leave my mobile phone number and give her the number of the hotel in case it doesn’t work. Then we stay on for a while with Miles and we tell him all over again how much we love him, that he is coming back to us and we will be with him every step of the way as he begins his recovery, that we are all here waiting for him.

We leave the hospital and return to the hotel and try to think what we can do to take our minds off this huge thing that is happening. The process is already under way in Miles’s body, the drugs slowly ebbing out of him as in turn the Miles that has been shut down, the undamaged parts of the Miles we know, must surely be coming back to take their rightful place. Marina speaks for us all: this hope, she says, is like the beginning of a love affair, the intensity of it, the newness. She is right; there is the waiting and the tenderness in hoping, the absorption of all one’s self into just this one encompassing fervent desire, and the dream, the beautiful dream, of fulfilment.

The evening comes, and the night, and there is no call from the hospital. Dr. Stizer said it would be a slow process. Walking towards the hospital in the morning we are walking to a scaffold where there may be a stay of execution. It is raining and the mountains ringing the town are hidden from view for the first time since we’ve been here. The streets are bleak; rain has put the city off kilter, it should be snow at this time of year and the ski slopes will be ruined.

Sitting once more in the waiting room, we watch the fish in their tank. There seem to be some new ones, none of us remembers seeing them before. They are black and larger than the decorative bright little fish that swoop so hopelessly through the seaweed. These new ones are purposeful, their sucker-like mouths fastened to the rocks as they clean off the pale green scum that has grown there, and two of them are fastened on the glass front of the tank, sucking and cleaning the glass. The movement of their mouths is repellent; I can’t watch them, they’re starting to make me feel nauseous.

The nurse is coming down the corridor to fetch us, her face impassive. She lets us out of the waiting room and we follow her in silence, still not able to speak as we go through the rigmarole of putting on plastic aprons and rubber gloves and then continuing to follow her past the nurses’ station and through the ward to Miles’s room. We enter and there he lies, in the same position as he was yesterday, on his back with his eyes calmly closed, the machines still blinking out their messages behind him. The straps have gone. It might have been a dream; reality seems very far away. But the dream has ended; the removal of those straps is the rejection we dreaded, the end of the affair. There was no need for them. He is still in a coma but it is his own.

A week goes by and there is no change. Then, suddenly, during our visit this morning Miles moves his arms. He pushes both arms downwards, stretches them down with his wrists bent back in the way one does sometimes, pleasurably, after sitting or lying too long in the same position. The shock of excitement—he’s moving! he’s starting to wake!—becomes tinged with alarm as he repeats the movements forcefully but his face remains blank, unchanged, his eyes closed, no flicker of expression. Such a powerful action, yet the rest of his body has remained inanimate. Even so, I can’t help calling out to the nurse who is busy filling in forms behind his bed, Look, look, Miles is moving! She drops what she’s doing and comes around to see and I’m deflated by her lack of enthusiasm. Surely she can’t be so cynical or impervious to the significance of what happened—since Miles has been in a coma this is the first time he’s made any movement of any kind. Later the young doctor comes in on his rounds and I tell him eagerly what happened, describing and imitating it to show him. Surely it has to mean something is changing? I ask him. It was such a strong action, does it mean Miles is beginning to surface? He is quiet for a moment. We don’t really want him to do that, he says. I’m afraid I think it may just be a consequence of his injury. But it is still early, he adds quickly, don’t worry, it will pass. He is being kind, trying to rescue me from my foolishness, my ignorant optimism. I’ve no idea how someone wakes from a coma, but every moment of watching Miles is geared to this end. I am consumed by the hope of it.

Now it is terrible to watch him make that movement. Each time I want to stop him, No, Miley, no, don’t do that, please don’t do that thing. The innocence of it, and the horror; his brain is in chaos and all the while he stretches out his arms as though he’s just about to get out of bed after a long nap. Decerebrate posturing is the medical term, Dr. Stizer tells me later when I ask him; sympathetic storming, or just storming, is the more common description. Such a strange and beautiful word for it, I say to Dr. Stizer, and he looks at me quietly. It will pass, he says. What he doesn’t tell me is that DAI may contribute to it, or brain stem injury, that doctors fear it because the action itself may suggest further injury is taking place in the brain. I don’t know that yet and for the moment hope regains the upper hand—the doctors have said it will pass and, most important, it has shown us he is definitely not paralyzed.

I have a photo of Miles lying on a sun bed by the pool in France. It was taken from the lawn above the pool and he is looking up at the photographer wryly, caught off guard just as he was surfacing from a post-lunch snooze in the sun. His body is tanned and fit, his dark hair thick and ruffled from swimming. He is stretching both arms downwards, the wrists bent back, an enjoyable long, lazy stretch. It is a precise replica of storming.

At first it was shocking to see how many tubes were tethering Miles to the world, but I have got used to them now. This morning when we visit, the nurse tells me that the doctors have decided to remove the one that passes through his mouth directly down into his airway, the endotracheal tube.

It was the first emergency tube used by the paramedics in that fearful helicopter journey. When he collapsed on the mountain slope they had to ensure he was getting enough oxygen, and the initial procedure would have been to administer it through a mask fitted over his nose and mouth. But when his pupils registered as unequal it signified a further emergency. The endotracheal tube would have been inserted, jammed down, I imagine, in the rush to save his life, before being connected to a portable ventilator to keep him breathing.

The nurse tells me now that prolonged use can damage the vocal cords over which the tube passes and since it has been in place for three weeks the doctors consider it time for removal. Please let his voice not be damaged, that warm, humorous voice I know so well. In place of the tube Miles will be fitted with a tracheostomy, she says. I have no idea what a tracheostomy is and so the nurse describes it to me. Involving a minor operation, a curved plastic or silicone tube will be inserted into a hole made in Miles’s neck and windpipe just below the larynx, bypassing the vocal cords and leading directly into his airway. It is necessary to keep his airway open and accessible, so that it can be cleared mechanically if necessary or used to administer extra oxygen when needed.

The young doctor on duty today has been deputed to discuss this with me and ask for my permission to perform the operation. He tells me that it is a simple procedure and there is very little risk of complication, that once the tracheostomy, or trachie as he calls it, is no longer necessary it can easily be removed leaving only the smallest scar. Having discussed it with the rest of the family I give the go-ahead. The most important consideration for us, all we can really think of, is that Miles’s voice should be saved; our sweetest dream is to hear him speak again in the particular vivid, engaged way that he does.

Will and I are the first to visit Miles after the operation has been performed. I don’t know what to expect but the shock of seeing the tracheostomy in place undoes me completely. I am not at all prepared for the collapse of misery it brings me to; I can only sit down and bury my head on Miles’s chest, pressing my face into his inert body to try to staunch the torrent of pain that, if I let it go, is threatening to bring this precarious thing I hold inside myself to its destruction. Will’s hand is resting gently on my back, he is talking to me. It’s okay, Mum, it’s the best thing for him now, he says, we have to try and remember it’s only temporary and the doctors say there won’t be a scar. Lifting my head from Miles’s chest I am on a level with the trachie and however right it is for him now I hate it, I loathe its monstrous, domineering protuberance. It looks predatory, fixed, foreign; it has claimed him, branded him. A hole has been cut in this strong young man’s throat. I remember the Adam’s apple that appeared in adolescence, the strange ambulations in his voice as it began to break; I remember his smooth vulnerable teenage throat. Imagine the cutting that has had to take place—surely the windpipe is cartilaginous. I stand up with Will’s arm supporting me and look down at Miles. He lies unmoved and unmoving, his face serene, the hard plastic ugly thing with its crude white rim standing proud from his throat. There is this one comfort: that of us all, Miles in his coma is at least not suffering.

Good Friday morning, and I am surprised to learn that Dr. Stizer will be performing a cranioplasty on Miles this afternoon. I would have thought that being a public holiday there would be no surgery today, but he says they will be working as usual. He has come to see me in Miles’s room, and Claudia and I listen as he tells us that the piece of skull, the “flap” that was removed to make space for Miles’s swollen brain when he was first admitted, is going to be replaced by a piece of titanium. The original piece of bone, frozen in a solution to prevent infection, was kept so that it could be copied precisely to make the titanium replacement that would eventually be inserted to protect the brain. I ask him what the procedure will involve. The titanium piece will be fixed to Miles’s skull, he says, and then stops. Looking at me closely, he continues. Are you sure you want to know the details?

Perhaps it’s unusual, but I do. I would like to be present during the operation, see it taking place, see the area of unprotected brain before it is covered, just as I wished I had been with Miles at the time of his accident. I want to understand every element of what is happening to him. I don’t want to be protected from it—why should I be? It doesn’t make me feel squeamish, nor does knowledge make the situation any more painful.

Well, Dr. Stizer says, and I can see he is choosing his words with care, I will use screws to fix the titanium plate to Miles’s skull. You mustn’t worry, he adds quickly, the screws are very short, they won’t damage his brain. They are self-drilling. When his hair grows again you won’t know it’s there.

Miles’s body, it seems, is being adapted to survive his new life. First the PEG, or percutaneous endoscopic gastronomy, a feeding tube, was surgically inserted directly into his stomach, then the tracheostomy was fitted, and now this, his skull fixed with self-drilling screws; it is as though he is being armed for survival.

Easter Sunday is four weeks to the day since Miles’s accident. I can’t help it, but the combination of four precise weeks falling at Easter feels imbued with significance, though of what exactly I’m not sure. Perhaps some atavistic stirring, that Easter is a day of hope, of a rising from the dead, of new life beginning. Lying in bed in the hotel room with Ron next to me, here for the weekend, I try to suppress the strange excitement that something is going to happen today. It feels like a private premonition that I will ruin if I speak it out loud, so I don’t mention it to Ron, and instead we talk about our plans for the day. He thinks perhaps it would do us all good to go out for lunch after visiting Miles. I can see how exhausted you are. It’s Easter, and everyone’s here; it’ll do you good to have a treat. He plans to take us to the restaurant with a sheltered garden near the Hofgarten, the beautiful Imperial Court park on the edge of the Old Town that we have often passed on our walks through the town. We can sit outside and enjoy the sunshine, he says. I’ll book a table. In my superstitious state even his suggestion seems significant; he is attuned to Miles, maybe he, too, senses that something is different today, that finally there may be something to celebrate. Spring has arrived in Innsbruck and the town has come to life, window boxes now blooming with color and the trees in the somber winter parks alight with new growth. Everything suggests renewal; surely Miles will be part of it.

As we gather together in the hotel foyer after breakfast I try to gauge if anyone else is sharing this feeling I can’t shut down. Maybe I am oversusceptible, but somehow the atmosphere feels heightened. Perhaps it’s just that Ron is right, I’m exhausted. Stepping out all together from the dim interior of the hotel into the bright spring sunshine I wonder if it’s visible to others, how fragile a group we are, how taut with uncertainty. Reality feels fluid; nothing is fixed anymore.

Turning the corner into the plaza for a moment I think I have truly lost my senses. Huge white rabbits are dancing in the sunlight to music played by three wizened old men dressed in Tyrolean costume playing squeeze boxes, their short leather trousers, long white socks, and feathered hats making them look like ancient schoolboys. The normally sedate cobbled space is a riot of noise and color, small children racing through stalls laden with elaborate breads and cakes, bright marzipan sweets, painted eggs, colorful wooden toys, and all the while the stout men and women dressed in their rabbit costumes are, I now realize with even more bewilderment, selling loops of giant sausages as they regale the crowd. We wend our way through the surreal scene, smiling politely at the stallholders as they offer their wares and dodging the happy children as they run around us.

Our destination, when we reach it, seems just as surreal. My superstitious hope is irrelevant to Miles as he continues to lie, oblivious, on his high hospital bed.

The senior consultant on the neurosurgery ward is Professor Benir. He introduces himself and explains that he has been in America at a medical conference, which is why we have not met before. His manner is quiet and thoughtful, his dark Middle Eastern features severe against the crisp white of his doctor’s coat. We are standing by Miles’s bed and he looks down at him, studying him silently for some time before he turns back to me.

I would like to know about your son, he says.

And so I tell him about Miles. That he has been a joyful son to have, my firstborn child. That from the beginning he has been quick and bright, an adventurer, a risk-taker. That one of the things that has defined him has been his brain. After academic success throughout school he got a first-class degree from Oxford. He started his own company at twenty-four. At twenty-five he was selected as one of five young people to represent Britain during Giscard d’Estaing’s European Youth Convention. At present he is a management consultant for a large international company based in London but will take his own company further when he has gathered more experience. He is writing a book in his spare time. He likes to keep fit and enjoys white-collar boxing. He skydives, he dives with sharks. He practices qigong. He makes electronic music. He writes poetry. He is funny. He is kind. He loves life, attacks it head on, dangerously, seeking adrenaline, sometimes foolhardy, learning from his flaws while exploring, always, his spiritual resources. He is full-blooded, down to earth, but at the same time he is an intellectual.

I’m boasting about my son. But what seems important is that Professor Benir should know about Miles’s brain, the brain that he and his team are now responsible for. He must know that it is exceptional.

I apologize for boasting, I say to the professor, but what I have told you is true and it is breaking my heart that one of the things defining Miles was that he was an intellectual and now he is brain damaged. I find that the most difficult thing to come to terms with. I wouldn’t mind anything else, his legs, his arms, anything, but not his brain. He used it with such vitality, it was crucial to his enjoyment of life, right down to his particular wit and sense of humor. Can I ask you for the truth, Professor Benir: what form is this brain damage going to take?

He waits some time before answering. Miles lies quite still next to us, only the faintest movement visible as his chest rises and falls with the intake of each breath. Now that the swelling in his brain has subsided, the shunt that was draining off the excess fluid has been removed. There are no longer any tubes coming out of his nose or mouth; the tracheostomy and PEG have taken care of those. Void of expression, his strong, closed face is intimidating in the stillness of its silence.

Professor Benir looks back up from Miles to me. The damage is not to his intellect, he says. That is not the area of the brain that is damaged. But he has suffered a very serious trauma to his brain. What is crucial now is that he begins intensive rehabilitation. We have done our work here, the surgery is complete; the important thing now is for you to arrange the next stage for him. We could move him to our neuro-rehab clinic forty kilometers from Innsbruck but I think it would be best for him to return to England, where you and he will be at home. I would recommend the Acute Brain Injury Unit at Queen Square in London, the National Hospital for Neurology and Neurosurgery, which has an excellent reputation for neuro-rehabilitation. And please, he says, gently laying his hand on my arm, don’t worry about boasting. I asked you to tell me. I wanted to know about him. I am very sorry that this has happened to your son. I wish him, and all your family, very well.

Now we must get Miles home—how, and where to, such obvious and crucial questions that we have deferred facing for the past five weeks. Such a lapse seems extraordinary, though for a time we had talked of staying in Austria until he was well enough to leave. We know better now. And so we get to work, David, Ron, and I researching London hospitals that offer neuro-rehabilitation, contacting anybody we know who might be able to help or advise us. Friends who are doctors are invaluable, generous and patient with their time.

It takes a week of intense negotiation. After a flurry of telephone calls to London hospitals Miles is finally offered a bed in the Intensive Care Unit at University College Hospital, to be reviewed and assessed before being moved to the Acute Brain Injury Unit at Queen Square, the ABIU. Our twin goals have been the ABIU and the rehabilitation ward at the Wellington Hospital, both centers of excellence specialising in neuro-rehabilitation following traumatic brain injury. The Wellington is private, however, and the costs are prohibitive. Receiving the news that Miles is to be admitted to the ABIU feels like winning the lottery.

The logistics of flying home are daunting. To return on a stretcher with a commercial airline would require the space and cost of nine seats, but patients with tracheostomies are not accepted so that is ruled out anyway. There are companies that specialize in repatriation by air ambulance, small jets that have the intensive care equipment to cover every eventuality, but talking to their representatives I get a chilling sense of impersonal service at great cost, that the payment is more important than the patient. Dr. Stizer recommends a friend of his, a doctor who flies a private air ambulance, and the decision is made.

Today Miles and I are flying back to England. On the runway our plane is dwarfed by everything around it. Tiny but purposeful, it looks like a hornet waiting for takeoff, fragile, thread-thin legs and delicate wings outstretched. The airport is closely ringed by high mountains, snow-covered, jagged and implacable, and I cannot imagine how this tiny thing will lift us over them. Once inside the plane you cannot stand upright yet unbelievably there will be six people on board. The pilot, Dr. Stizer’s friend, is a handsome, swashbuckling neurosurgeon who flies for a hobby and often ferries his own or other intensive-care patients. His exuberance makes me realize how brittle I am, how taut and isolated is the space I’ve come to inhabit. His co-pilot looks reassuringly serious, a young man who shows great concern for Miles as he is being lifted into the plane. There is a male nurse from the hospital, and he and I sit belted in with our backs to the pilot and co-pilot, our shoulders almost touching theirs. Relaxed and friendly, the nurse tells me that he is now studying to be a doctor but takes on this work when he can to earn the money and for the ride, and, I can tell, this outing to England will be fun for him. In front of me, almost taking up the body of the plane, Miles lies on his back on a stretcher and I can just about reach across and touch his head to reassure him, or reassure myself. Next to him, at the other end of his stretcher and facing us, sits a young woman doctor; throughout the journey she monitors Miles and fills in the clipboard chart she keeps on her lap. Beside her is a bank of resuscitation equipment and a portable suction machine. Once the plane has taken off we can’t talk, because the noise of the engines is deafening; this air ambulance has no luxury trimmings.

I don’t like flying at the best of times and I especially don’t like flying in small airplanes. This is the most physically frightened I have ever been. I fear the laid-back pilot, the tinny fragility of the plane, the grinding noise of the engines, the low altitude and proximity to the snow-covered mountains below us; above all I fear the effect of the rarefied cabin air pressure on what little oxygen is still being supplied to Miles’s brain. Half an hour into the flight I begin to detect an unmistakeable smell of burning; yes, there is undoubtedly something burning in this airplane. I lean over to the nurse and he leans towards me. I shout in his ear, Can you smell burning? Mmm, he says, and turns to tap the co-pilot on the shoulder. They talk closely and then the nurse undoes his seat belt and crawls, bent double, down to the back of the aircraft. I can’t see what he is doing as he crouches down but he returns calmly and now shouts in my ear, Heating, the heating, better it’s off, okay?

I nod but I’m not okay. Miles has begun to judder, his body jerking, his head shaking terribly from side to side. The doctor leans forward to take his pulse and check his oxygen saturation level, then sits back in her seat. He continues to judder and I think he must be sensing something through his comatose state, that his unconscious registering of the change in his environment is triggering these severe spasms. I can do nothing to soothe him, except let my hand linger on the top of his head and try to will my love through to him, to enfold him and cocoon him with all the force of my love.

Ridiculously the plane lands at Biggin Hill, with its connotations of Biggles, the adventurous pilot of the vintage schoolboy comics; how Miles and Will would have loved that as small boys. It’s a beautiful day, and as Miles is lifted out of the plane and on to the runway I realize it is the first time the sun has shone on him for six weeks. His skin has a ghostly sheen, his immobile eyebrows and closed, thick eyelashes unsettlingly dark in comparison. I can see that the two young men wheeling his stretcher try not to look at him too obviously, but it is unusual to see someone in a coma at close hand and they are both fascinated and repelled. Miles is still a handsome, powerful, athletic-looking young man in spite of his pallor; his rigid unconsciousness shocks. An ambulance is waiting outside the small airport and the cheerful driver helps me in. You sit next to me, love, in the comfortable seat, he says. You must be a bit out of sorts after that flight. The medics can go in the back with him. He’ll be all right, don’t you worry, love.

He talks all the way to London, turning on the siren whenever the traffic looks bad ahead. That’s the joy of these things, he says, gets you where you want to in no time.