My Year Off (6 page)

Lying in the National Hospital, of course, I was ignorant of these statistics and these kinds of affliction, but I could not escape the wholly unscientific sensation that while some irrepressible quirk in my bloodline had dumped me in this predicament, at the same time some peculiar longevity-gene had saved me from its direst outcome.

Of all my conscious moments at the National Hospital, the nights were the worst. Night is when the patient imagines dying. It was at these moments that I was most acutely conscious of the stark truth that everyone faces in hospital: no amount of loving care and attention (and I was greatly blessed in this) can disguise the fact that a dramatic illness emphasizes our solitude and isolation. We came into the world alone and, no matter what prudent provision we make for the future, we shall leave it alone. As Pozzo says in
Waiting For Godot
, ‘They give birth astride of a grave, the light gleams an instant, then it’s night once more.’ If I had a headache at night — like the harbinger of the stroke itself — my first thought was: I’ll be dead in the morning; I’ll never see Sarah again.

In fact, she would appear at my bedside, with unfailing good humour and a cheery, clarion ‘Good morning!’ at about eight o’clock, immediately after the hospital breakfast (coffee, a choice of sausage or bacon, juice, and cold toast, accompanied inevitably by a tiny plastic cup of Lactulose, a sickly sweet laxative), bringing fresh clothes, the day’s post and the British newspapers, her addiction. Then I would be wheeled off by one of the nurses to have a bath. This was a laborious and exhausting process during which I tried to forget that the nurses were literally manhandling me, moving me in and out of a wheelchair specially designed for use in the bathroom, levering me into the bath and then washing me all over. There’s no place for privacy in hospital.

Sarah’s presence, and her optimism, soon chased away the demons of the night, and we quickly evolved a visiting routine in which her role was to control the flow of visitors and quiz the doctors about my progress and my likely recovery. As an American, Sarah was used to a level of information and medical advice that British doctors, who seem to cherish the mystery of their profession, still find slightly unnerving.

My doctor, Andrew Lees, an elegant, soft-spoken neurologist of great natural warmth and wisdom, advised me to think of the bleed in my head as a kind of bruise; over time the scavenging macrophage cells would literally eat up the damage to the cerebral tissue, leaving that part of my brain permanently disabled. I could see for myself what he was talking about. An early MRI scan located the bleed, a menacing black blot, deep in the brain at what the medical report said was ‘the proximal right middle cerebral artery at its trifurcation’. Over time, the sinister stain would shrink and fade, but, despite this brilliant pictorial representation, I am, even
now, two years later, no nearer an absolutely reliable explanation of why that bleed occurred in the first place.

It is the special peculiarity of the affliction called ‘stroke’ that its dynamics remain mysterious. The absence of an explanation for such a thunderbolt enhances the sense the stroke-sufferer has of being a victim of a malign fate. While about 40 per cent of all strokes are unexplained, the same uncertainty accompanies the process of recovery. I believe this is unnerving for patients and doctors alike. In medicine, the contract between the doctor and the patient is based on trust and a supposition of expertise, of knowledge. When my rehabilitation specialist, Dr Richard Greenwood, a tousled, academic-style neurologist, widely acknowledged to be the head of his profession, sheepishly confessed to me that doctors are actually quite ignorant about the brain, it was oddly comforting. At least we were somehow all in this together.

None of this uncertainty discouraged the Queen Square doctors from returning obsessively to the scene of the crime. Had a clot originated in the chambers of the heart? I was sent off for a trans-oesophageal echo cardiogram. Was the thyroid to blame? I gave yet another sample of blood for analysis. The secrets of the body in question will not stop modern medicine from asking myriad questions. Despite these investigations, which occupied much of my attention during that first month in hospital, no one was able to advise how long I would be incapacitated. This made things maddeningly difficult, at times even frightening. Would I ever walk again? When I first fell ill, one doctor told Sarah that I’d spend the rest of my life in a wheelchair, and for several weeks every doctor she spoke to gave the vaguest of answers to this simple, and most fundamental, question.
In the absence of reliable data the experts took refuge in a frustrating reticence, a studied vagueness; ‘probably’ I’d be fit in ‘about a year’. After six months, it would be ‘fairly clear’ how much movement would return to my left side; then ‘perhaps’ my arm would become ‘useful’. Meanwhile, I was still profoundly restricted, anxiously watching for evidence of brain-repair; on the rare days that my left side began to respond it was as though I had discovered a sixth dimension.

Such moments of joy were rare; I cried a lot in hospital. Sometimes the tears were slow and weepy; at others, uncontrolled and desperate. I could cry for any reason and none; I was told that this is characteristic of stroke victims. Dr Lees also assured me that those parts of my brain which control memory, thought and personality were unaffected; but Sarah was naturally concerned that I might have suffered a change of personality. I have since learned that this fear is exceptionally common among the carers of stroke-sufferers. In turn, the terrific psychological pressures arising from stroke can lead to the irretrievable breakdown of many relationships. Sadly, ‘stroke’ and ‘divorce’ seem often to be closely linked.

I became aware of Sarah’s anxieties when I noticed, with some amusement, that she was surreptitiously leafing through the pages of the notebook in which I’d begun to keep a record of my experiences. I feigned sleep and watched her checking the latest entries, presumably looking for tell-tale gibberish. I resisted the temptation to fill a folio or two with ‘all work and no play makes Jack a dull boy’, like the deranged Jack Nicholson character in
The Shining.

I did not pray. Several visitors later asked if, having ‘looked into the abyss’, I’d experienced any religious emotions, to which I can honestly reply, I did not. What
I did find was that the world seemed almost unbearably precious. Shut away in my room, with the finest English summer in memory scorching outside, I had a craving for sky, earth and sea, which I satisfied in the oddest way by watching sport and nature programmes on television.

In the hours of reflection that followed the end of
Channel Four Racing
, I would brood on the paper-thin gap between health and sickness. As adults we forget that we live in our bodies. The unexpected failure of the body is a shocking catastrophe that threatens the flimsy edifice that we call the ‘self’, especially when one is reduced to the condition of a baby. In
Hannah and Her Sisters
, Micky Sachs, a grand-prix hypochondriac, decides he has a brain tumour. ‘Do you realize,’ he moans, ‘what a thread we’re all hanging by?’

The irony is that this kind of drama was precisely what I’d been looking for. Now that I come to write about it, I find I cannot explain my former addiction to physical risk except to say that I think of myself as a coward who wishes he were not. It seems to me that my need to search out the dangerous parts of the world comes from my fascination with history. For me, history is made up of hazardous turning points and dangerous corners – encounters, skirmishes, battles, insurrections – in which the individual is tested against the cold steel of the historical process. There is also the thrill of visiting a terrain that is utterly unfamiliar and physically punishing. And then there’s the unavoidable competition with my father, who had served on HMS
Victorious
in the Pacific as a junior navigating officer in the Royal Navy during the Second World War and had known the thing that those of us born after 1945 will never know. I
suspect this unconscious competition is common to quite a few men of my generation.

Somewhere I had acquired a taste for the intoxicating smell of jet-fuel and rotting vegetation: I had to see new places, experience new things. In the spring of 1993 – some months before my final flirtation with adventure, the journalistic trip to that Indonesian hell-hole, the island of East Timor – I had gone with the photographer Tim Page to Cambodia during the UN-supervised election.

When I was lying in hospital, unable to move, it was this South-East Asian journey that came to haunt my consciousness, as I faced up to the possibility that I would never travel again. Just as I had spent that first day of my year off lying at the corner of the stairs under a brown-green map of Cambodia, so I spent the subsequent weeks winding in my imagination through the sub-tropical jungles of Indo-China, reliving those lost moments of danger. As the American writer, William Maxwell, puts it so memorably, ‘I have liked remembering almost as much as I have liked living.’

Imagine a country whose people have been killing each other without mercy for twenty years or more, a country whose fields have been seeded with millions of lethal anti-personnel mines, and whose main political parties also deploy private armies. Imagine a land of violent, despotic traditions, rife with malaria and malnutrition, a land virtually without laws, clinics, metalled roads, safe water or telephones. And then imagine deciding to hold a democratic, Western-style election here. Neither a surreal joke, nor a nightmare fantasy, this was Cambodia, 1993. The UN presence (UNTAC) was, quite simply, a fantastic invasion by one of the strangest
armies ever to march into Indo-China: multinational troops from countries as far apart as Algeria, Poland and the Philippines; big-bottomed civilians, pallid spooks, bright-eyed do-gooders, yuppie careerists, and a cluster of foreign correspondents, conflict-junkies who would not have seemed out of place in films like
Apocalypse Now
or
The Killing Fields.
Among the American ex-pats in Phnom Penh at that time was the journalist Nate Thayer, who would later track down and film Pol Pot as he faced denunciation by his people in a jungle on the Thai–Cambodia border in the months before his death.

Tim Page and I were invited to join one of the daily UN fact-finding trips into Khmer Rouge territory, a journey that would traverse the world-famous Angkor temples, then still off-limits to civilians. We found two UNTAC officers who gave our driver the information that a mine had exploded the night before, injuring five people, one seriously – the planting of mines was often a clue to imminent military activity – and we drove deeper into no man’s land. No one seemed to know anything about the mine. The road had become strangely empty. Suddenly there was a radio-squawk, our call sign. We listened. Word had come through that the road ahead had been mined by the Khmer Rouge. For the first time that day, everything seemed dangerous. There were discoloured patches of sand further down the road. Were these mines? Who could say? We were not inclined to risk finding out. At the nearby Bangladeshi base, the battalion commander, an impressive young officer in charge of about forty troops, told us that the day before, at midnight, a young man had been brought in, horribly mutilated by the mine blast we had been told about earlier. The captain, at considerable personal risk, had driven through the darkness to get the victim to the
provincial hospital. ‘Every day we get a mine injury,’ he told me. ‘
Inshallah
, he will live.’

After we had returned to Siem Reap, Tim and I made our way to the provincial hospital. Between three hundred and seven hundred people a month are maimed by mine blasts in Cambodia. In Siem Reap, local casualties filled an entire wing of the hospital. As we approached, we passed the families of the injured, cooking meals and washing clothes in the courtyard. Inside, a crushing heat and the stench of sickness; it was like stepping into another age. There was no air-conditioning, not even a fan. There were beds in every corridor, with men and boys of all ages recovering from amputations. The look of utter hopelessness on the face of a Cambodian amputee was hard to bear, and harder to forget. Eventually we found our casualty. He was lying, tended by his mother, near the doorway, weak from blood loss but alive. His right hand and both legs below the knee had been blown away. The stumps were heavily bandaged and covered in a
krama
(the traditional Khmer check scarf) to keep off the flies. His name was Liu Loeun. He was twenty-one. If he was lucky, he would receive prosthetic treatment; if he was not, he would end up begging for dollars from tourists in the ruins of Angkor. When I think of him now, I consider my disabilities trifling in comparison, and so they are – I have all my limbs – but I know from my own experience some of the mental anguish he will have gone through. I recall the tenderness with which his mother, at his bedside, soothed his brow, a stark reminder that at such moments perhaps only our mothers can supply the love we need.

During that first surreal day at home in Islington, I had called my parents instinctively, and not merely
because theirs was a telephone number I knew by heart. The longer I stayed helpless in hospital, the more I came to understand why it is our blood relations who will respond, instinctively and without question, to the claims of family. Since my divorce from my first wife, I had lived in a world seemingly outside family, but there were moments during those first hospital days when it seemed that family was the only world that mattered. At the time, I could hardly express the thought, but I found it intensely moving to see my father in his London suit nobly and indefatigably appearing each day at my bedside, while my mother moved about among the nurses in the background. And at the centre of this new world was the tirelessly supportive, uncrushable, smiling figure of my wife of two months, my beloved Sarah. If I were now to reduce my experience in hospital to two key words they would be ‘family’ and ‘love’.