Authors: Robert McCrum
It is now two weeks since I came here, and although it
seems an age, in another sense it’s no time at all. Today a nice bunch of letters from America. I have received some extraordinary letters since I first came here, a whole sackful, in fact, with some very nice thoughts from the most unlikely people. I realize that people have been extremely shocked by what has happened to me - and more shocked than I have been in some ways - although I have perhaps not yet come to terms with what’s happened.
While I continued to adjust to what had happened, my doctors were already planning to move me out of the National, where bed-space was at a premium, to a longer-term specialist rehabilitation hospital where I could concentrate on reactivating the parts of my body that were no longer functioning. I was offered a choice of two, including the Devonshire, an institution renowned among physiotherapists for the comprehensive service it offers the rehab patient. Sarah, true to her American attitude to health care, was determined to check out the facilities herself rather than take a doctor’s word for them.
Sarah has just gone off with Matthew [
Evans
] to inspect the Devonshire Hospital, and I have Mahler’s third symphony playing on the Walkman. I am slowly learning to accept my condition, but the point about it is that I have no real idea how ill I have been, or might be again.
At this time I still feared a recurrence of the stroke, a recurrence that would kill me, I was certain. In fact, the likelihood of such was extremely slight, and not long into my convalescence Dr Greenwood reassured me
that, statistically speaking, I was extremely unlikely ever to suffer a stroke again.
Today I managed to sit on the commode and have a good ‘bowel movement’ (the nursing euphemism) after lunch. Amazing how much things like this come to matter when you’re a patient - I have become quite obsessed by my digestive processes, in short by my bowels. No nice way to say this. The nurses always refer to it in that way. They say, ‘Have we opened our bowels today?’ rather as if they were asking, ‘Have we opened our post today?’ Which I find hilarious. That is their big concern, I suppose. Besides death, constipation is the big fear in hospitals.
My face feels still numb around the jaw, as if I have had an injection from the dentist. It has been this way for some days now, but seems to be wearing off slowly. My speech, though slurred and difficult, is better than it was. I have made a note here to look up the word ‘autoclaving’, a word that seems to be written on the bottles that are given to us for urinating into.
Some of the other patients, especially the Arab diplomatic staff who occupy many of the other rooms here, seem to bargain and haggle over the cost of rooms, so if a room costs sixty pounds, they’ll haggle and say ‘How about twenty-five?’ One of the nurses said skittishly the other day that they sometimes expected to be paid with a string of goats or sheep. There are, in fact, a lot of Arab patients here and thus a lot of Arab jokes. Mr Haifa next door is known as ‘Jaffa Cake’. His visitors stand on my balcony and smoke cigarettes in the evening and chat, as if they were in Beirut.
Today in the elevator I encountered my worst fear, a
twenty-something woman with a neat incision in her head, a shaved skull, and stitching like a rugby ball. She smiled at me in a glazed way, but did not speak, and we passed like ships in the night, and I found myself thinking about her all afternoon. This is what I was afraid of when they first brought me in - the fear that they would cut me open and operate on my brain. But apparently they don’t do this now; they used to, but don’t any more.
The thing about Queen Square is that there are all sorts and conditions of people here, often very acute cases, and you do see some extraordinary sights. In the physiotherapy ward there is an elderly, emaciated Arab gentleman who has what are known as ‘antlers’ on his head. This is a kind of metal brace designed to keep his head upright on his spine. It looks very peculiar, but I have got quite used to it now. There is also an AIDS victim suffering from brain damage, who drools and groans, and can’t stand upright. He is very haggard-looking and very sick, with Kaposi’s sarcoma all over his face.
Last night I had a terrible headache which stopped me sleeping. For a while I wondered what would happen if I just conked out there and then. The nights are often the worst - the night is a time of fear, and wondering if I will survive. I feel very lonely and frightened then. I found myself going over the previous six hours and wondering what Sarah would say if she found me dead, and how she would cope. I love her so much, and she has been so wonderful while I have been here.
While we were watching our wedding video, I found myself crying uncontrollably. Partly they were tears of rage and tears of frustration, and tears of love for Sarah
in her predicament, and tears of happiness that I should be married to her - to someone as wonderful as her, and perhaps tears of relief, too. One thing I really admire is the way Sarah continues to work at her journalism while visiting me in hospital.
Today I have a new physiotherapist, John, who is small and wiry and dark, and rather good. He is much less pernickety than Sandy the amusing Scot has been, and concentrates on my legs. At the moment there is no movement from the left arm, but there are a few ‘flickers’ (that’s the word they all use) in the left leg, and I can now sort of raise it up so that my knee is bent when I am lying in bed.
It’s another boiling hot day. There are standpipes in Yorkshire, on the television. Today I discover that Dr Click’s husband is a publisher of educational books, which explains why she has been so keen to discuss books each day. I also discovered that Dr Lees’s first name is Andy or Andrew, not Adrian, as I had thought. (He still seems to me like an Adrian, not an Andy.)
I still find I can’t keep track of time. I don’t know why this is.
The headache makes me feel very irritated with the inefficiency of the ward. It’s still not clear when the [
illegible
] people will come, or when will I have the final transoesophagal cardiogram test at the Middlesex Hospital. I think back over the first two days after the stroke, and remember lovely Wicce St Clair Hawkins, the tawny-haired nurse who was so kind and thoughtful to me in the beginning.
This morning, en route from my bath, I meet nice Dr Lees in the hall. For some reason, I feel intensely embarrassed to encounter him out of bed and so obviously vulnerable in my wheelchair. He tells me he is still trying
to track the causes of the stroke, and says he has found antibodies in my thyroid, but no clot in the chambers of the heart. I am too unsure of myself to ask what any of this means, in practice. He says, none the less, that he wants to do the transoesophagal cardiogram, an investigation of the chambers of the heart.
Susan [
Sarah’s mother
] rings from Maine. She sounds to be in fighting form, and it will be nice to have her back here soon. She has been so wonderfully supportive during these difficult weeks.
I discovered today that Sarah is also writing what she calls a ‘psycho-diary’. God knows what she is putting in it - probably complaints about my bad temper during these last few days. One of the things about the irritation of being in hospital is that there are so few people you can take your irritation out on. So she has become a lightning conductor for my rage. The one thing that will always calm me down, I’ve found, is being read to. Sarah has a fine reading voice, very pleasant and soothing and I look forward to our reading sessions.
The Lion, the Witch and the Wardrobe
brings back so many memories of childhood. We sit in a shady green part of Queen’s Square, and read aloud to each other, or rather, Sarah reads aloud to me. She reads very pleasantly, and it’s restful to sit in the cool of the evening, watching the winos on the benches in the distance while the gnats buzz over our heads in the twilight.
It was the measure of my loss of confidence in myself after the stroke that my biggest fear on these outings was that I’d run into someone from the Faber office across the square. At this stage, it was still my ambition to recover enough fitness to be able to resume my old life as editor-in-chief. The more my convalescence unfolded
the more I came to recognize that I could not possibly cross the square back to my old job. At first, the constraint was physical; as time went on, the reservation became psychological. It seemed depressing to acknowledge that forty-odd years had been tossed casually into the dustbin of history.
I dread seeing a colleague [
I wrote in my diary
] to whom I’ll have to explain myself. We always choose a time when everyone’s gone home, i.e. after seven o’clock, and on the whole we aren’t disturbed. We go to the far end, behind the statue of Queen Charlotte, and sit under the trees. I have taken this square for granted for so long, have walked through it and round it, not thinking, and now here I am, an integrated part of its little eco-system, and I am quite a bit grateful for the greenery I can experience here. I do occasionally feel very sad that I can’t have more of the summer to myself.
The dusty trees of Heaven and bedraggled rosebushes of the square became all the more precious as battered, metropolitan representatives of the English countryside that I could otherwise glimpse only on television.
Today, a very cheery visit from Robert Harris [
friend, and author of
Fatherland], who arrived with some Fortnum and Mason biscuits and a bottle of Krug vintage champagne. What a good friend he is! People say the most extraordinary things in hospitals - Robert said he felt ‘very envious of my experience’. I think he intended a joke, but I was not in a mood for irony and said, rather coolly, that he was welcome to it. We agreed that would
both have dinner at the Manoir au Quat’ Saisons with Raymond Blanc when I get out. Apparently Raymond Blanc had a stroke some years ago, and has now made a full recovery. Well, that’s some kind of role model.
I know it’s going to be a long haul. But it’s hard to adjust to that. I dreamed last night that I had polio [
her father had suffered polio as a child
] and couldn’t walk. For a bit – but that when I started to recover Robert still had it far more seriously. I felt pathetic and weak and sorry for myself, while my side was paralysed. I keep wondering what this is like for him. I feel very alone and very scared. I look at him – I know it’s not fair – and I pray that his leg and arm will start to move again – right now. The doctor has just come in and said there is no way to predict what he’ll be like in 12 months’ time. Robert has a raging headache again. I am so afraid that it means that something else will happen. I think I will always be afraid, for the rest of our lives. If it was bad before, my worry is a hundred times worse now. Everything seems so precarious. It’s hard not to feel a real panic, a constant sense of being overwhelmed, as if you’re drowning.
It’s getting better, but slowly, and the people you deal with in positions of authority really are quite unable to offer much reassurance. The thing is, I think they don’t know. Robert’s left leg is moving a bit, and also his left shoulder, but not his arm at all. His speech is almost back to normal, except when he talks quickly – then he tends to stutter. My moods go so up and down – euphoria when he seems to be making progress, despair when he doesn’t, a sense of dread all the time. The hard part is the feeling that you have to have all the optimism in the world to help the person get better, while
preparing yourself for the very worst outcome. I’m not sure how to get both of those at once. People say I should take it one day at a time, but that’s hard to do.
The Middlesex [
Hospital
] has just rung: I may not eat or drink till all the tests are done today. This is because of the anaesthetic I shall have to take for the transoesophagal operation. So the thing about being a patient is that you have to accept whatever the medical profession decides, without complaint, and if, like the guy down the hall, you refuse or disobey, there’s a big crisis.
A bit later Dr Chandra – young, impressive, well dressed – comes in to describe what the next lot of tests will be like. There will be a camera down my throat, then another blood test. He says that after six weeks they can make a fairly good prediction of what sort of recovery I should have in the long term.
The operating staff, in their green gowns, float about the hospital like actors backstage. In the operating theatre they are on stage of course, and this is where the real drama is. The back of the hospital is just like a Richard Rogers building run amok – blackened air vents and wrought-iron fire escapes. The building roars like a hive of bees in the hot sun, and I sense that microbes, perhaps a hundred years old, are lurking in the rust of the metal. There is a curious intimacy in a hospital – nobody has anything to hide. Once you are here you have to expose every part of your body to the nurses. There’s no privacy. As well as this, you are weak and they are strong. This can make nurses seem like sadists or authoritarians.
The truth is that [
the members of
] the medical profession hate a mystery, though actually they live with it
every day of their working lives; they have to know the reasons for things, and they have to be in control. The thing then about having a stroke is that they don’t know why it happened, and they are not in control. As a patient, all you can do is to lie here, and allow time to take its course, and time to heal. There is no other cure. If I was in an African village I would have no different a treatment: the fact is that I have had almost no medication since I arrived here, apart from anti-depressants, and the only future medication will probably be an aspirin a day.
Today the nice Chinese nurse Philippe (the one they all call ‘Phirrip’!) gave me a mirror to shave with. I find myself with a sad, defeated expression that reflects my inner mood after nearly a month here. The good news is that at least my facial appearance is not hideously deformed, as I believe it can be.