The Emperor Waltz Read online

  But upstairs, now it was clear that I was going to be staying longer, I asked the staff if there were some pyjamas I could wear. They brought some clean orange ones, a colour few people would choose. These orange pyjamas, like the uniforms at Guantánamo, had an institutional air. Their colour was meant not just to be ugly and, for white men, very unflattering – I later shared a ward with a black patient who looked magnificent in his orange jim-jams – but to distinguish the ill as a class from the many different sorts of medical caregivers. The tea-pourers, the takers of blood, the junior nurses, the senior nurses, the junior doctors in their white coats and their stethoscopes, like avant-garde necklaces of rubber and steel – they all had their uniforms. And so did the patients, in their orange pyjamas and their hospital gowns. Only the senior doctors and consultants and the administrators who walked about importantly had no uniform, and, of course, they dressed in exactly the way that consultants and hospital administrators are expected to dress by society. I felt that, as a matter of urgency, I should get hold of a pair of pyjamas from home, and some other means to detach my condition from its institutional setting. I envisaged a framed photograph on the wheeled bedside unit, a favourite book, a pen and a notepad, and some pyjamas and a dressing-gown to impress my individuality on the minds of the doctors, like a hostage to kidnappers.

  Albert Ward was where I ended up. In a state of isolation, I had texted a dozen friends overnight, telling them where I was and cancelling any engagements I might have had. I was supposed to travel to Germany the next day, where I was chairing a writers’ conference, and directly on to India to the Jaipur festival to promote a book. Now, in the morning, on Albert Ward, my phone was pinging with messages back – expressing horror, concern, practical help, and, from my husband, who was in Geneva, a promise that he would take the first plane over in the morning. I was surrounded not just by professional care, but by the investment of relationships, in some cases, decades old.

  The ward contained six beds, separated from each other only by blue pleated curtains that could be drawn forward and across for privacy. The window at the end of the room contained a view of the long, metallic, sinuous path of the river under a morning January sun. At the far end was a vast, tattered old man, whose rasping voice, devoid of consonants, suggested the ravaged survivor of at least one stroke. In time I discovered that he had survived five: for the medical profession, he was the object of wonderment disguised as admiration. They did not seem at all curious about his success; they just came to wonder, almost in benign amusement. Opposite was a man waiting for an operation on his knee. In the middle bay was another survivor of a stroke, but mute and incapable of efficient movement on one side. He communicated with bell and gesture, indicating with his good side what he needed. He patiently nodded or frowned at suggestions from the nurses. He was called Robert. Somehow, his limited capacities allowed him to suggest that he was requesting things with polite diffidence and not expressing impatience when responses were slow or obtuse; he indicated the grey cardboard pisspot, even, with politeness and gratitude in his index finger. I could never understand how he did this. The nurses loved Robert, and spoke to him with special consideration and warmth.

  The ward had, like all hospital wards, its own disinfected smell and, on top of that, a particular stew-like odour. The clean, blasted smell was overlaid at lunchtime by a rotting, organic sweetness. As the day went on and turned into evening, the smell clarified itself and grew stronger. By six, it was clear that you were smelling shit. When in the morning you went to shower and returned to the ward, the stench of human shit was overwhelming. It remained like that until its source, an Irishman called Joe, was argued into being taken for a shower by the nurses. In his absence, his bed was stripped and its mattress washed down. He would return momentarily roseate, his washed hair in a clean shock about his stunned, sideways-on head; he would lie down. In half an hour the characteristic stench would start to drift over again.

  Joe had an ally in the bed opposite, another Irishman. I never discovered the other Irishman’s name, because the nurses never used it, and Joe might have forgotten it. This second Irishman was a cut above Joe socially, though he, too, wore the institutional orange pyjamas. His family visited and telephoned – a mark of distinction in the ward. His skin seemed to be his problem. It was red raw, and he had to be swabbed like a deck with lotions and unguents until he shone scarlet. He was a short-term inmate. Joe, on the other hand, was in for as long as he could wheedle and contrive.

  At ten each morning, shortly after having to submit to being forcibly washed, Joe would begin his demands.

  ‘Nurse,’ he said. ‘Nurse. Can you take me out, please, for me cigarette, one small cigarette only?’

  The passing nurse might ignore this. The mornings were their busy time, and they had to be about to help the doctors making their rounds. If one stopped, she would say only, ‘Not now, Joe,’ and move on.

  There was no risk of not discovering Joe’s name. The nurses and the doctors hated him, and they used his name all the time.

  ‘It’s a fucking disgrace,’ Joe would say, to his friend opposite.

  ‘You’re fucking right there for once, Joe,’ his friend replied. ‘A total fucking disgrace. This place is a fucking shambles.’

  ‘It’s just one fucking cigarette I’m after,’ Joe said. ‘Nurse. Nurse. Nurse.’

  ‘What is it, Joe?’ a nurse said. She stood there, her hands on the blood pressure trolley, her hair scraped back like that of a 1970s hostess. ‘I’m very busy, Joe.’

  ‘I just need a cigarette,’ Joe said. ‘That’s all, I need one.’

  ‘Not now, Joe,’ the nurse said. Her name was Lucy. Joe never used it. ‘Not now. We’re all very busy. You know you don’t get taken out until after lunch. If Mario has time, after lunch, he’ll take you. You know that was what we agreed, Joe.’

  ‘She’s a fucking disgrace, that one,’ Joe said, when Lucy had almost gone. ‘Jesus, it’s just one fucking cigarette I’m after. What a fucking shambles.’

  ‘I’m out of this fucking shithole,’ his friend remarked. ‘Just as soon as I fucking can, Joe.’

  ‘Once you’re out,’ Joe said, ‘that’ll be the last I see of you. Ah, you’re all the fucking same. The few who are nice to your face – even them – they can’t wait to be fucking shot of you.’

  ‘Ah, don’t you be like that,’ his friend would sometimes say. ‘Sure, I’ll be back next week, don’t you think otherwise.’

  I doubted this. The morning went on. Joe took, after some time, to pressing his patient’s buzzer, intended to summon a nurse. He understood that the purpose of the bell was not to reiterate a request that had already been made, and fabricated another purpose to be offered up at first.

  ‘What is it, Joe?’

  ‘Nurse, I need some of those pills of yours.’

  ‘What are you talking about?’

  ‘Those pills that get you over your withdrawal, Nurse. It’s bad today. It’s real bad.’

  ‘Joe, I’ve told you before. You haven’t had a drink for six weeks. You were brought in six weeks ago, remember? You’re not suffering withdrawal symptoms. I can get you a paracetamol if you’re in pain. Are you in pain, Joe?’

  ‘Ah, Nurse, when are you taking me out for a cigarette? You promised. It’s not fair. I need a cigarette. You’re depriving me. You all hate me.’

  ‘Joe, I’ve got to get back to my job. You’ll be taken out after lunch.’ Then an evil thought evidently crossed the nurse’s mind. ‘If someone has some time to spare.’

  In the days that followed, I overheard Joe’s story in bits, some repeated frequently, some brought out just once. His head was twisted grotesquely on his neck, almost horizontal to his shoulders, and only one arm appeared to work at all. Sometimes these injuries were ascribed to the experiments of the medical profession. Joe would tell a nurse or his friend that he had had not a problem, not a one, with his head or neck until the day he had come into hospital. Sometimes they wou
ld be blamed on a car that had hit him. Had this accident happened just a day or two back? Or was it impossible now to discover which of Joe’s enemies had been driving the car, because it had been months or years ago, and the police, everyone knew, were very good at losing clues and evidence and that when it suited them? The one detail that never changed was where the car had hit him. It was always ‘just where the Kennington Road makes a big curve, you know what I’m referring to, coming into the Elephant and Castle roundabout, where you can’t see the traffic coming, not for the life of you’, a detail so precise and yet lacking in accord with London geography that it made me think Joe’s familiarity with the world came and went at his own convenience. ‘I don’t know who’s behind all of this,’ Joe would say, his feet waving in the air as if he could summon somebody with the movement of his toes. ‘But I can take a fucking guess.’

  ‘You’re right there, Joe,’ his friend would say, in happy disgruntlement. ‘You’re right on the fucking money.’

  There was a strong and inventive strain of paranoia in Joe’s world, and its presiding principle was that Joe had never done anything wrong in his life. The sister who never came to visit, God knew what was behind that, the old bitch – it was only slowly apparent that she had been living in Australia for twenty years. The nursing staff who had failed to take him out for a cigarette were neglecting him out of deliberate malice, and the doctors had carried out the experiments that had left him in this sorry condition. Now they were trying to remove him to one of them hostels – but Joe knew what they were like. They were places where your money and your property were stolen by any passing little runt, and the poor innocents they got molested by them child molesters before you could say knife. That wasn’t going to happen, no fucking way.

  ‘You stick to your fucking guns,’ the friend in the bed opposite remarked comfortably. ‘You don’t want them to be putting you in no fucking hostel. You want them to be putting you in your own fucking home.’

  It was news to me that Joe had a home of his own.

  ‘I don’t want to be put in my own home,’ Joe said. ‘Jesus Christ, that shithole. Look at me. Look at the fucking state of me. There’s no way I can cope on my own. No, I’m staying here, where them fucking cunts can experiment on me all they like. I wasn’t like this when I came in here. There was nothing wrong with me six fucking weeks ago.’

  Joe’s paranoia that something lay behind his current state that nobody was prepared to acknowledge or investigate was shared, to some extent, by the hospital’s medical staff. It became apparent that though Joe had now dried out, and his various old injuries, his twisted spine and his abandoned-toy-soldier neck and sideways-on head, were considered by the hospital not susceptible to treatment, there was the question of his incontinence and his catastrophic digestion. Joe and the medical profession had reached a well-constructed impasse. Every morning’s doctors’ rounds ran the same course. The doctors would assert that Joe’s condition needed to be examined. Joe would say that there was no fucking sympathy for what he was going through. The topic and the respective positions in the argument were so well established by now that the doctors and Joe talked allusively before slipping, on both sides, into impatience. It took three days before I understood that Joe’s condition couldn’t be diagnosed accurately without a colonoscopy. He was steadily refusing permission for this, and insisting that the doctors were refusing to discover what was wrong with him. Without an accurate diagnosis, as Joe knew quite well, it would be hard for the hospital to discharge him. For this reason, he went on refusing the colonoscopy.

  I thought long and devotedly, but skirting over the details, about the gentleman whose professional duty it was to undertake colonoscopies into incontinent alcoholic Irish tramps.

  To keep out Joe’s conversation, it was possible to put on earphones and listen to music on the iPad. I did that on my first morning, setting it to select things at random, and it gave me, in no predictable order Bunji Garlin, the septet from Les Troyens, Miss Platnum and the Emperor Waltz. To shut out Joe’s smell, or to do anything about it, proved harder. I thought of those eighteenth-century town-dwellers who walked the street with a posy clutched to their nostrils. The nurses tried to make sure that Joe was washed by the time the consultants came round in the morning. It reflected, I suppose, on their care if the senior doctors found a patient caked in day-old shit. While Joe was gone, his Irish friend in the bed opposite tried to engage passing nurses in conversation.

  ‘Ah, it’s a relief when he’s gone, even for a minute, isn’t it?’ he said. ‘You know what’s the worst of it? It’s the language, I swear to God. It’s disgusting, what comes out of that one’s mouth. I’ve never heard the like. I tell you what, Nurse – there’s not a chance of a cup of tea for me, would there be?’

  But tea was rationed, coming round at regular intervals, or only for the relations of the dangerously sick, and he was unsmilingly told to wait until the proper time.

  ‘Ah, I’m looking forward to getting out of this fucking shithole,’ he remarked, when Joe returned from his shower, clean, startled, stunned-looking and wide-eyed, like a well-rinsed owl. ‘And being able to get a cup of fucking tea when you feel like it.’ A malevolent look flickered over his face; he controlled it, his fingers fluttering over the grey bedpan in his lap, and his face turned to an expression of studious blankness. ‘Or something better – a couple of pints in the pub with your old mates. Just a couple, enough for a drink, make you feel you’ve had a fucking drink, not enough to render you incapable.’

  ‘I don’t know where my mates are,’ Joe said. ‘They’re all fucking cunts. I never want to see them again. They can fuck off. And my fucking sister. She knows I’ve been here for six weeks, dying, and no sign of improvement. Where the fuck is she, my own fucking flesh and blood, the shite.’

  ‘It’s sad when you’ve no mates,’ his friend said. ‘Me, I’ve got hundreds. I’m like him at the end with the fucking flowers and the fucking queue of visitors.’

  ‘Ah, him,’ Joe said. ‘Him with the roses. Nurse, can you take me out for a fucking cigarette, now, you’re treating me like a cunt.’

  ‘Not now, Joe,’ Lucy said, walking past. The flowers were tulips, brought by my friend Richard. But otherwise Joe and his friend were right. I had been lucky in the number of visitors I had had.

  5.

  In the space of the ward, contact with the world was exiguous. What I remembered best about a previous three-week stay in hospital when I was fourteen was how very odd the world looked when I came out: sparkling, cold, fresh. I had had the sense of everyone moving quite gingerly through its air. On this occasion, since I didn’t feel ill, I had no compunction about taking the lift down eleven floors once or twice a day to the cafés and shops that were making money out of the hospital’s unclinical lobbies. In my pyjamas, slippers and dressing-gown among the crowds, but licensed in my déshabillé, I felt inexplicably invisible. Nobody looked at me, though to be caught in public in your night- or sick-wear is a familiar dreadful dream of conspicuous discovery. I think they were perhaps tactfully averting their eyes, since nobody wants to be caught staring at a person who is seriously ill, or just insane. The lift upstairs was a capsule returning me to an enclosed, epic and safe world. It was easy to see how a week or two would rob you of any curiosity about the world, even where your nurse had come from that morning, even about the long, laden boats sliding noiselessly over the grey-surfaced river below, with the silent pregnant greatness of the boats in Homer. For this reason, the nurses and other medical staff would be surprised and vulnerable to any genuine-sounding or interested enquiry in their circumstances. I banked on this.

  The lack of curiosity about the world was strong in Joe and his Irish friend. I put it like that, since the lack seemed a positive, even an energetic, quality of decision and the averted head. I never heard them ask a question that wasn’t aimed fairly directly at extracting a favour for themselves. Their sight could have extended only three feet from the bord
ers of their bed, taking cognizance only of what happened to blunder against them. Beyond that, there was nothing but inaccurate speculation, a world made out of rage-filled fantasy, sentimental constructions – those hundreds of imaginary mates in the pub – and a great emptiness of malice. Of the world they knew and saw and cared nothing at all, and those blundering and aim-directed objects came into their circumference from nowhere, and went on to nowhere, to do nothing further once they were detached from Joe. Joe’s imagination did not fail. It had never begun to work. The ward existed in a kind of void that from time to time provided a laden trolley with tea or machinery or medicine. From time to time, the remote end of the bed would be crowded with white-coated dignitaries. They would shake their heads, metaphorically speaking – in reality, one or two would raise their heads and gaze penetratingly at nothing in particular while the rest hung their faces over their notes, hoping not to be addressed. Below, on the river, long empty boats, like yellow shoeboxes, went from right to left in the early morning’s mercury-shining light; in the early evening, the same boats went from left to right, bearing ribbed burdens of iron-boxed waste, and the boats sank deep in the water with their new weight. Where did they come from, and where did they go to disgorge themselves? In the placid world of the ward, I looked down from the steel-framed window and began not to care.

  Joe and his friend had forgotten all about the world, and the world had certainly forgotten about them. There were few visitors to the patients in the ward; the quintuple stroke victim had a visit from three gigantically obese people, his daughters and a grandson. A sharp-faced girl with skin as red as a scrubbed thing turned up, and spent exactly ten minutes with the other Irishman. Outside, in the world, polemicists and activists were arguing that it was a tragedy that the physically infirm and helpless had been forgotten about, were ignored by society. Up here, the physically infirm had forgotten not only about the world, but even what to do to enquire about it. They knew their nurses’ first names, since they sometimes wanted to call one to do something for them. More than that they could not venture, and would have been astonished to discover that normal people could not live in such empty boredom without enquiring about idle details. But, of course, they were normal people: that was what life made of normal people, friendless and incurious, attended only by the dutiful, who had no choice in the matter.