bracken: chapter 6

This is the first draft of a novel which I have decided to publish on the blog chapter by chapter as a work in progress. Any comments, suggestions, etc will be much appreciated. It will only be up temporarily. 


When I wake up, I can hear the cars passing on the road below the hill. They make a sound like tearing paper. I can hear the sound of a horse in the triangle field. I can hear the thud of the hooves on the turf. She is being put through her paces. I hear her gallop, and then slow as she approaches the hedge and turn at a walk and then gallop again across the field. I can see it in my head. I can hear the twigs of the branch scraping at the slates of the roof. A job to be done. Take that branch off with a chainsaw before the next gale force wind turns the twigs to prying fingers, capable of damage. 

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I lie on the bed a moment and shift myself to just find a more comfortable position. My mobility is coming back slowly and though occasionally I am gripped by a panic that this is it, I have enough evidence accumulating that I am getting better and there is more progress to be made. I am determined to get better not through any notion that I can have my life back, that I can return to normality, but rather that whatever life I have left I want to make the most of it.

I can see the ceiling. I can see the sunlight across the ceiling. The sun is coming over the fell at my side. The fell that then runs behind my head and up to the Lakes, the Old Man of Coniston in the distance.

I can smell the tang of the yard and the fields. I can smell the waiting rain. The light darkens and shines as clouds pass quickly over the face of the sun. It will rain this afternoon.

I can see the window and through the window a slice of sky, blue with scudding clouds and a slice of sea.

Last night, we sat around the table and they talked. I ate some cake. And Caroline helped me drink tea. I have a rubber ball and I flex it in my hand as they talk. I like it. I like the feel of it, the sensation of having some effect on the world, other than being a hopeless burden on it.

Elaine sat at the head of the table and seemed distracted, checking her mobile, taking calls and occasionally leaving the room if the conversation was going to be protracted. Agatha is in her twenties and has her hair in pigtails. She looks like a grown up version of Pippi Longstockings, an observation that I suspect wouldn’t upset her. She seems very nice and she is very attentive of me. She holds my hands and says to me, staring into my eyes, ‘I have heard so much about you.’

‘It’s so good to have Michael back,’ she says.

I want to correct her. But it is ungenerous, since she is someone who is so obviously over flowing with love. She pats my hand occasionally and watches Caroline and Elaine with something approaching adoration.

‘Tommy and Mags are coming next week,’ Agatha tells Caroline who sighs.

‘We have people staying in the static caravans,’ Caroline says to me. ‘We have four caravans there now. We’ve converted the barn and we have three self contained flats that can be rented as self-catering and there’s a nice meeting room which we’ve been using as a conference centre. The planning permission was a nightmare, but in the end it came through and we got it done really quickly after that.’

‘Locally sourced materials,’ chips in Elaine, an eyebrow raised to show is impressed with herself.

I have heard about this intermittently. I have even had legal papers to sign throughout the last seven or eight years as Elaine and Caroline turned the farm from the failing agricultural enterprise it was to the now successful mix of lodging and retreat. To be honest though I haven’t been paying that much attention and I never read further than the cover letter. Sensing this, Elaine always placed stickers where I had to date and sign the documents.

I had not once contested their decisions.

The tea tasted of a handful of grass boiled in water. Maybe a daisy or two.

‘We put you in your old room,’ says Caroline.

I nod. Sometimes I am tired and I get angry and I know this. But I didn’t want to go to bed. I had slept so much in the car and I would sleep easily I knew, but I might die in my bed tonight so really what was the point in always sleeping?

‘People are coming from all over,’ says Agatha. ‘They’re very excited.’

Elaine’s phone buzzes and she checks it. Elaine’s mind is elsewhere. She is impatient with this conversation.

‘It’s going to be a shock after Italy,’ she says to me. ‘It’s going to be hard for you.’

I make a gesture with my hand, a gesture I hope of carefree dismissal.

‘We’ll do our best,’ says Caroline. ‘We’ll take you to the hospital. We’ll get you on your feet again.’

I would like to speak again. I would like to join in. But the effort is beyond me. The words are in my head but they bounce and hit each other, unable to get out.

‘What would you like to say?’ says Agatha. She place my pad before me; the pencil in my hand. I smile at her and scrawl, ‘HAPPY 2 BE HERE’.

‘Awww,’ says Agatha and gives me a big hug and I breathe in her smell. At last a woman who doesn’t smell of hand sanitizer.

Agatha knocks on the door and opens it. She is holding a tray. I move myself so I am sitting.  She places the tray on the bedside table and then takes a chair from the other side of the room and brings it over so she can sit close. The mug says ‘The United Nations.’ Inside is water. Hot water. And a lemon pip floats under the wispy steam.

Agatha brings it to my lips, I blow and I take a sip and she puts it back on the tray.

‘Did you sleep well?’ she asks.

I nod and she nods and smiles. ‘It’s going to be a brisk day,’ she says, looking out of the window. We sit for a moment in silence. I move my arm. I don’t like moving it with her here, but I can’t wait any longer. I have to check that I can move it. I touch my leg, feeling for feeling. I flex my fingers and rub my thigh.

‘I’m sorry, Michael,’ Agatha says. ‘I must seem really forward to you. I feel like I know you so well. Caroline talks about you all the time. And Elaine and Caroline have been like family to me. You know I was just wandering, wandering through life when I met Caroline. I wasn’t going to ever amount to much. Chances were I was going to end up dead. I don’t know how. Suicide or drugs. Most likely a man. Men are so dangerous. Men are the worst.’

She is playing with her bracelet when she says this and then looks up at me and beams her beautiful smile.

‘Oh, present company excepted!’ she says, laughing.

I reach out with my hand and take her hand and hold it. I don’t mean anything by it. I just mean. It’s okay. You don’t have to speak. I squeeze her hand, hoping that she can feel what I am trying to say. She looks uncertain. She looks down at my hand as if I have breached some line, troubled. But then her face relaxes into a happy smile and she gazes frankly into my face.

‘Yes, I know,’ she says. ‘I know.’

Caroline comes in. She looks at me and then Agatha and then back at me.

‘Hospital,’ she says.

Agatha goes downstairs with the tray and Caroline helps me out of my bed. She is not embarrassed by my body, by our proximity. She jokes and teases me. She tells me I have bad breath and I need a shower. I don’t mind. The bathroom has been converted. I can sit down in the shower, and so I will be fine. All the handles and doors are of a height that I can manage and there are easy to reach emergency buzzers placed all over the house.

‘We already had these in,’ Caroline tells me, though I don’t think that is true. ‘We’re very aware of being accessible for everyone. Including the differently-abled.’

I know that Caroline is only teasing with me when she says I smell, but I am going to be very careful with my hygiene. It’s something I noticed in hospital at Lamon. You are lying in bed all day in your pyjamas and it is very easy to lose all sense of personal hygiene. The environment around you is kept clean, but a hospital is basically a large body. The bathroom door always seems to be open. There are fluids draining into bags and from bodies. Everything is out there and it is easy to see yourself as just a cell of that body. A cell that cannot control its own destiny. I must escape this mindset. I must regain to the utmost my autonomy and my dignity. I feel an intense urge to tell Caroline to fuck off, but I push it down. She is helping me and she loves me and if I am to be her patient, I won’t make it worse by being unhappy. It is my duty to be happy and grateful and to enjoy life.

Showered and dressed with Caroline’s assistance I feel better. Halfway through dressing me she stopped talking. And we proceeded like that. It’s better. I feel the silence is more honest. I can tell what she’s thinking and when she stops talking I have the impressions he can finally here me. She laces up my trainers and she looks up at me.

‘I’m sorry,’ she says. And then helps me down the stairs. 

 

This morning I have an appointment with the doctor and then my physiotherapist.

Caroline has a big folder with my name on. She puts it in her bag with her pens and her phone and wheels me out to the car. Everything is a pack. I have a pack about my medicines and one about my exercises. There are check lists and everything is laminated and glossy so I can dribble on it without worry.

We drive down the lane and over the cattle grid, pull out onto the road and wind our way through to town. The wind pushes at our car every now and then so that it shudders like the turbulence that occasionally attacked the airplane yesterday.

Furness General Hospital is on a hill looking over Abbey Road. I used to go to school just off that road. The bus stopped on Abbey Road and we walked down Rating Lane to school. There’s an Abbey there called Furness Abbey that was destroyed. I had a friend at school whose mother was a local history buff and would talk endlessly about the history of the abbey if allowed or in any way encouraged. Seagulls wheel above our heads and a windmills swing in the wind on the hills in the distance. A large HGV rumbles down the road.

Caroline pushes me through the corridors and passed various reception points. There are TVs playing in the waiting rooms. They play information about how to treat burns and avoid accidents. ‘A BIT LATE NOW’ I scrawl on my pad.

Caroline smiles, but she doesn’t get what I want to say. There is now a film about the early signs of a stroke, so she suddenly understands and laughs as the man rubbing his arm collapses.

FAST comes on the screen in big letters. And then the words ‘Facial weakness Arm weakness Speech disturbance Time to call 999’. 

A teenager with a bandaged neck bangs the vending machine until his Lion bar drops from where it was jammed. Our doctor comes through. She is a small Asian woman, I assume Pakistani but I don’t know.

Dr. Ani she is called. She introduces herself to me and spends a moment looking over the papers that Caroline has filled out. She also has the papers that the Italian doctors have emailed her printed out.

She sits behind a desk. Her computer open on a page I assume to be my file. The desk seems to big. There are some photographs of children and an older man with a heavy toothbrush moustache. It has a stripe of grey down the side which makes it look like each wing of the moustache has come in a different colour. A spider plant cries havoc on the windowsill.

‘So….’ Dr. Ani says slowly as she finishes reading. ‘Michael, is it okay if I call you Michael? Yes? Good. You were in Italy then. Wow! It must be a bit of a culture shock to be back here. I’m afraid my Italian isn’t very good, but luckily your doctors in Italy have sent me everything in English and between them and Google translate I think I understand basically where we are at. This is your sister?’

‘Caroline,’ she says.

Dr. Ani smiles at her.

‘Your sister might be able to confirm some of this information as we go through it, but please feel free to intervene if I say something wrong.’

I nod.

‘About three months ago you suffered a severe Ischemic stroke resulting in the temporary paralysis of your entire body and speech loss. You have since recovered mobility mostly on your right side. You have a limited ability to walk and you have the use of your right arm and hand.’

‘That’s right,’ says Caroline. 

‘Still no joy on the speech loss, though?’

‘No,’ says Caroline. ‘He can sometimes grunt and make some kinds of noise, but no words yet.’

‘Okay that’s something we’ll have to sort out,’ Dr. Ani says. ‘Hmmmm?’

I nod.

‘Now as far as I can tell from the note the Italian doctors have provided, you have undergone an intensive course of physiotherapy and there has been a course of anti-coagulants, anti-platelet, which is only to be expected.’

‘Do you have difficulty swallowing?’

I nod.

‘Sometimes he needs help.’

‘You have to be very careful with that,’ Dr. Ani says. ‘There’s a leaflet in your pack that will give you a test to do, before you eat.’

We both nod.

‘And you are sleeping?’

I nod. But I pull a face.

‘Some difficulty? 1 to 10, 10 being insomnia.’

5 I scrawl.

‘Okay,’ Dr. Ani takes a note. ‘Pain management. We have some quite powerful pain killers here. Are they proving effective? How much physical pain are you in again on a 1 to 10 scale? 10 being unbearable.’

6 I scrawl.

Dr. Ani takes another note.

‘Uh huh,’ she says. ‘That will be helped by the pain killers but we could do with trying to wean you off them.’

She reads over something the Italian doctors have written. They joked about their English and asked me to look over it for them. The English was poor but not in any way that actually mattered.

‘That all seems fine. And how are you from a mood perspective? How are you handling it, Michael? If you were to rate your mental state 0 being you have no problem, 10 being extremely upset what number would you put to describe your state of mind?’

That’s a question.

I write 5.

I can see a minor flinch, but the doctor covers it well.

‘That’s very good, considering everything you’ve been through. Your occupation is…’

‘Michael was a language teacher,’ Caroline says.

‘Is a language teacher,’ Dr. Ani corrects. ‘Yes. Your students must be missing you. And am I to understand your residence in the UK is now going to be…?’

‘For the foreseeable future,’ Caroline says.

‘Right,’ Dr. Ani for the first time looks directly at Caroline. ‘And you will be Michael’s primary care provider?’

‘My sister Elaine and I will look after Michael, yes.’

‘Now, you’re going to have a busy schedule, Michael. You’ll begin a new course of physiotherapy and see if we can keep up with the improvements that you have already made. We’ll do some speech therapy as well and see if we can’t make some progress there with the Aphasia. The good news here is that we’re still in the six month window when speech can spontaneously return. It isn’t very common but it can happen. In case that doesn’t, then you need to prepare yourself for a long haul.’

‘What do you mean?’

‘It can take two years to regain understandable speech,’ Dr. Ani says. ‘There will be incremental improvements but it is a difficult process and requires a lot of work on your part Michael. But as I said, there is a chance that he will recover some of it himself in the next few months. And if not we have an excellent speech pathologist who will be working closely with you.’

Caroline smiles. ‘It’ll be great for Michael to get his voice back.’

Dr. Ani taps at her keyboard. She has a heavy metal necklace on that seems to get in her way a lot and she has long varnished fingernails I notice and some quite large rings.

‘Right then. Almost done Michael. Last thing for the time being, I would also like you to see our psychiatrist.’

‘Will that really be necessary? I mean Michael says that his mind is fine.’

‘You indicated 5, Michael, am I correct?’

I nod.

‘That’s not fine. It’s low I’ll grant you, but men of a certain age tend to perceive such admissions as weakness so Michael I hope you don’t mind, but I think you might be trying to put a brave face on this. Right now, with us, it is very important you be absolutely honest so that we can proceed with the correct course of treatment. As accurate as you can. No pride or vanity in here.’

‘But maybe…’ Caroline begins but she stops herself.

‘Go on,’ says Dr. Ani. ‘Please.’

‘I’m not sure how much I and my sister truly trust psychiatry and certainly psychopharmacology. I would not be comfortable with giving Michael that kind of treatment.’

‘I see.’

‘It conflicts deeply with my views.’

‘Yes,’ says Dr. Ani and she sits back for a moment in her chair. The leather clad cushions hisses a little as they ease around her body. She looks as if she is composing her answer carefully. ‘Caroline you and your sister are care providers but it is very, very important that you understand that Michael still retains full autonomy. It is up to him to make these decisions, and every decision to do with his treatment. Do you understand Michael?’

I nod.

‘Of course you might have strong opinions and you might wish to influence his decisions, but he must be allowed to make them with no pressure from anybody, beyond that exerted by good advice. You will be under a lot of pressure and I don’t have to tell you what a sacrifice this will entail, but as we all want Michael to recover to the best of his ability, then we have to start by protecting the autonomy and dignity that Michael still has. Do you see?’

‘Yes,’ Caroline says.

I can tell that Caroline is angry. She is angry as we find the physiotherapy department. She stays outside in the corridor as the physio moves my body through various contortions. The physio is a large man with a buzz cut and clean hands. He wears a navy blue cotton t-shirt and sombre track suit bottoms. He claps his hands and moves with well trained ease. His posture is exemplary. He talks constantly in a cheerful manner, utterly unfazed by my aphasia. He’s twenty seven or thereabouts.

‘I’m Sam,’ he says. ‘Just Sam.’

Sam claps his hands.

‘Here we go,’ he says as he stands me up. ‘Let’s talk about the first order of business Michael. Let’s get rid of that damned chair. You’re going to walk. Perhaps not well, perhaps not fast. But we’re going to get you walking again without the need of that blasted contraption, what do you say?’

I nod.

‘Good man!’ he says.

‘Put your hand here, okay. Now grip as hard as you can. Okay good. Now shoulder here. Move your hip as far over as you can. Good. There’s much more mobility here than you think. You just nee to develop it. Seriously. I’m going to show you some exercises you can do at home. Where are you sleeping? Ground floor?’

I shake my head.

‘First floor eh? They put you upstairs? Well, that’s good. We need to do that. We need to go up and down the stairs. Okay? Is there pain here? Tap my wrist if this hurts. Okay. Again. Okay.’

We have a forty minute session. I love Carl. He’s brilliant. I like his energy. I like his chattiness. I like the way he is friendly with me and when Caroline approaches him after the session he speaks over her head to me. He winks at me when he finally talks to her. ‘Your brother is going to sign up for the SAS when I finish with him. He’s going to be helicoptering into embassies to rescue hostages. No probs.’

We have time for lunch before the psychiatrist appointment.

‘It’s good they’ve put them all in the one bunch,’ Caroline says.

I can tell as she sits in the canteen and eats her sandwich that she is still playing over the argument with Dr. Ani in her head. I didn’t realize that she felt strongly about psychiatry one way or another, although perhaps I should have guessed. Both Elaine and Caroline have always had strong opinions about everything. They often argued with each other, but even more frequently they would simply agree and become a kind of echo chamber for the same opinion until it became bigger and louder and drowned out any opposition. They were vegetarians when they were fifteen and the arguments soon went from their own diet to everyone having to become vegetarian. Obviously, living on the farm made this sort of thing complicated. But Elaine and Caroline by their joint force somehow managed to overcome all obstacles. I developed a quiet form of resistance. I didn’t have opinions, or at least I didn’t express them. I found the easiest way to infuriate them was to agree with everything or refuse to react.

‘Michael you always do this,’ Elaine said once. ‘You wave the white flag. But for you the white flag isn’t a sign you’re surrendering, it just means you’re contemplating another battle front.’

That was very perceptive, although when she said it – I can’t recall the precise occasion, but it was in the midst of an argument – I made sure I just smiled and shrugged.   

So I listen to her rant.

‘I don’t want to influence you at all, Michael, but you don’t know how things have changed since you’ve been away,’ she says. ‘We’re just taking everything that goes wrong in America and we swallow it whole. We take any theory that is thrown at us by the psychiatrists and we accept it as fact. What is basically happening is behaviour is becoming medicalized. You’re shy? No of course you’re not shy, we can’t do anything about shy. There are no medicines for shy. But social anxiety disorder… yep that we can deal with. Your kid is a brat, jumps up and down, misbehaves, acts out… could it be the sugar and caffeine we pump into him or her? No! Could it be simply high spirits? You know childhood? No. There’s no pill for that. But Attention Deficit Disorder. Then we’ve got you covered. What is Attention Deficit Disorder? What is Social Anxiety Disorder? Well the key is the word disorder, which roughly translates as cod Latin for we don’t really know. What we’re doing is essentially collecting a bunch of observable symptoms together and reverse engineering an illness from that, that doesn’t in reality exist. Or better still we get a drug, work out what it does and then go searching for some symptoms that it can address. Even a side effect will do. Viagra was initially supposed to be for high blood pressure. Then they found the side effect that was more marketable.’

It is an advantage of living in a foreign country for a sizeable amount of time that your own language becomes something of a foreign language to you as well. When I first moved to Italy, I was obviously easily able to lot listen to conversations, understanding very little of them. Even as I learned more Italian and became more competent, I still retained the ability to tune out easily. It was and is a skill to be treasured. Being unused to hearing much English spoken, outside of the context of the classroom, I find that I can do the same. This is fortunate because Caroline does like talking. Her ideas I don’t doubt have a lot of merit, but when it comes down to it I’m not interested. I’m older now and I’ve lost that youthful idea that anything I can do, any idea I might have, will effect the world in one way or another. There are local kindnesses I am happy to carry out, and gestures which I hope will be magically transmitted to those around me so that if we have a hive mind of some sort then some good might come of it. But I no longer believe that if given the opportunity to sit down with the leaders of the world that I would have anything to offer of value.

Caroline and Elaine are still admirably enthusiastic when it comes to the world and how it goes along.

The psychiatrist is a woman with a bob of hennaed hair that she scratches with a pencil. She types into her computer for quite a while before she turns to me with an apologetic smile.

‘Okay, we’re going to do this like Gladiator. Your mental health is Russell Crowe and you are Joaquin Phoenix. Do you understand? Thumbs up. Good. Are you unhappy? Just give me thumbs up, thumbs down, and in the middle if you’re so-so. Okay. How do you sleep? Okay. Bad dreams? Good. Do you sometimes get angry? Okay. How often in a day do you feel anger? Okay. Are you lonely? Right. Do you feel that the people around you understand your needs? Good. Are you able to communicate effectively? Yeah, I know that is an odd one. But we mean given your difficulties can you… Okay good. How are you dealing with pain? Is there a lot of pain? How do you feel about your medication? Okay. Do you feel you are taking too much? Okay. Do you feel side effects? No. Okay. How do you view the future and your own possibility of recovery? Thumbs up for optimistic, sideways for … Okay you get it. Is this questionnaire upsetting you? No? Good. Did you like Gladiator? So, so huh? I liked it but Russell Crowe… A Russell Crowe covers a multitude of sins, am I right?’

I must confess I enjoyed my time with Dr. Petersen. She is a sharp woman with a sense of humour and she isn’t the least bit maudlin. It frustrates me to have to meet her under these conditions but I also felt that she was treating me like a human being and that somehow she could tell that I am someone worth knowing. It does wonders for self-esteem and I hope it didn’t effect my answers to the questionnaire.

What has been a tiring day is rounded off by a trip to the James Patel, the speech therapist. By this time I am very sleepy and so I’m afraid I catch very little of what he says. He gets me to make noise in a way that I don’t like but I understand what he is trying to do. He also tells me that we are to try and enable my alternative forms of communication as well. A series of gestures which I can use for the most rudimentary requests and messages. And also some new technology that I can procure which will also help me participate and communicate with the world.

We leave the hospital laden with packs and brochures. Or at least Caroline is. She has regained her humour. She is probably just glad to be away the way that I am.

She wheels me back to the car, chatting away about some article that Elaine has just written about the power of self-narrative as a road to self-improvement.

‘You’ll have to read it,’ she says.

I dread that this is going to be unavoidable and I wonder if I really want to regain my speech after all.