Dyce always knew he would be getting a phone-call or someone would be making one about him. Dad phoned about mum. A staff nurse phoned about dad, and now it was Older Brother’s turn. Dyce called him Oboe for short. It’s a wind instrument. Oboe’s daughter called during the Sunday afternoon cricket tea interval, and then his son, at one o‘clock the following morning.
‘He’s had a turn for the worse, you’d better come.’
Dyce packed a few things and went. Nothing else mattered. It all gets done whether you’re there or not. Sheila stayed with Louise and Chris.
Dyce feared the worst, but after two hours of wondering in the car, he discovered that Oboe was still alive, on life-support.
Hazel, Oboe’s wife, told them the story in the intensive care waiting room, ‘He hasn’t been well for a couple of weeks. Slow and breathless. A funny colour. He’s not been sleeping well, dreaming and restless. I insisted he went to the doctor’s on Friday. The doctor was concerned about the mental side of it, but you never know what he was told. We had to get the emergency doctor out eventually, he was so poorly. Once he was on the ward he stopped breathing and so he’s here on intensive care.’
A girl younger than a policeman appeared at the door, ‘You can come through now.’
Hazel and Dyce went. Hushed and dim, a single light on Oboe, coupled up to tubes, pipes and machines. The gasping rhythm of the ventilator. The quiet murmur of the night staff. Oboe had been deconstructed and the ghost was missing.
There was nothing they could do. The bad news messengers took a turn at looking at their dad. They all chatted for a bit, tearful. Then Dyce rang Sheila and went back to Hazel’s to sleep. The following morning Dyce rang work with his apologies. No, he didn’t know how long he would be off. He actually didn’t give a toss whether he ever went back, but he kept that to himself.
How does anyone manage? Aware of the anytime phone call, knowing he still lived. All of them in limbo, somewhere between life and death. They got a routine going, a semblance of doing something. Start with the journey three times a day there and back. The ritual dancing in the car-park looking for a free space. Took longer than the journey. Could be there for weeks, waiting for someone to leave and go home. A £1 a day mounts up. ‘Have you paid and displayed?’
Switch off your mobiles, no smoking, except outside the main entrance where a rubbish bin should have doubled as an ash-tray. The stone flags were littered with used tabs and squashed medallions of chewing-gum. Hazel got stuck here, when the automatic doors wouldn’t open. Dyce remembered the days when doors had handles which you turned, pushed or pulled. Maybe the car-parking fees bought the services of a cleaning company.
Then the long corridors full of modern art, the recently painted mixed building stock, and the flowers and shrubs. Beyond the entrance, Dyce sensed someone had recently made a big effort. Had they had a poor assessment by the inspectors? The gardening department was sound at least. Maybe it had a directorate, even a seat on the board.
The Intensive Care entrance was a single door with an intercom, nothing grand, for relatives anyway. Once inside, there were two waiting rooms complete with glossy posters, computer-generated cards in cellophane wrap. When Dyce was ready to read them, in a quiet panic-free moment, he realised they were all the same, at different heights on different walls, catering for tall people, short people, people with eyes in the backs of their heads, and people with short-term memory loss. ‘Switch off the TV when it’s not in use’, ‘Quiet periods are . . .’ It was sort of clear what was intended by the information, but Dyce couldn’t help wondering how something gets used if it’s not switched on and just what the patients did during loud periods. Intensive Care became their second home where they read the paper, did the crossword, drank coffee, ate sandwiches and sat at the bedside.
Oboe was unconscious, out of it. Sheet pulled up to the waist. Ample belly. He wouldn’t know if he was cold, and they took his temperature regularly, didn’t they? Dyce noticed a small bruise over his left eye. They say hearing is the last thing to go. Some of his visitors talked to him, giving him a blow-by-blow account of the day’s events. Others just sat and pondered the TV screens and their wavy lines, the bleeping, the flashing red lights and the hundred and one drips and tubes hung on a gantry over his head, draining somewhere into him, supporting life. Dyce noted how bleeping had become devalued, like an overused word, ‘nice’ or ‘situation’. Everything bleeped – mobile phones, the car if you left the lights on, the microwave, even the electric cooker. In his day a bleep was a serious alert, pay attention, you need to take urgent action. One evening between hospital visits, back in Hazel’s kitchen, Dyce jumped as the microwave sounded off. He looked around, ready for action.
‘It’s only the lasagne, Dyce, not the life-support.’
The first morning after admission, the head honcho took them aside after the ward round. Lots of questions – how long has he been unwell? Gradual or sudden? Yes he’s a heavy smoker, drinks a bit. Yes, he’s been deteriorating for a few months. Yes, it seems to have got worse this last two week or so. Couldn‘t get about during the day and wandered at night. Found out on the road once. The nights were clearly worse. Asleep but sat up, moving, restless, talking, falling out of bed. Hazel had to sleep in the next room. Did he snore? No, but he used to. ‘What’s wrong?’ asked Hazel. Oboe had a big heart, waterlogged lungs, low oxygen in his blood. ‘We think he might have a snoring disease; we had one in just last week.’ Somehow Dyce didn’t think so – probably the guy’s hobby horse, needs to get real, stay with the mundane. ‘Can we see you again? Can we make an appointment?’ asked Hazel. He slid away.
Dominic, a young fresh faced lad, seemed to be on top of things. Dyce worked out he’d been qualified five years. A specialist registrar. Dominic popped a camera down Oboe’s windpipe and discovered pneumonia. No white blood cells or other evidence that Oboe was putting up a fight. Immune-compromised’ – ‘run-down’ in lay terms or simply given up.
They couldn’t get in the ward at next visiting. Oboe was having a brain scan. ‘What’s that for?’ asked Hazel. The nurses weren’t sure. Dominic said it was a routine investigation in cases of confusion. Did we know if he’d hit his head? No, we didn’t. ‘Anything could have happened,’ said Hazel.
The days melted down into getting ready to go to the hospital, being there and coming home. Except the nights. Hazel and Dyce were alone, resting, and catching up, trying to make some sense. Things talked about that were never talked about at all those christmases and birthdays and barbequeues.
Dyce was aware of some of the story. Aware of Oboe falling out with his life, his family and friends and his disappointment with how things were. Apparent boredom and rudeness. He’d been a grumpy codger for a while, but Hazel said he’d moved on to no enjoyment in anything. Stood and looked out of the window, talked to himself. He was the only one who really understood. Nothing got expressed openly, all body language and short sharp testiness. He’d a couple of friends. Hazel was amazed they still were. Drinking and smoking large. Hazel knew this had changed his physical health. A time-bomb.
Dyce recalled their early life. The war years between them, a gap that might have shortened as they grew older. Dressed in the same things, but clearly different. Dyce skinny with wiry curly hair. Oboe massive by comparison, the bright first son with a mountain of expectations sitting on his shoulders. Reg, their father had angry and violent episodes. Oboe had to make himself scarce on many occasions. Too fond of answering back with a clever remark. Dyce had spent hours imagining what life for his dad would have been like. Newlywed and, hard to believe, starry-eyed in the late thirties. Proud when Oboe arrived. Overseas forever in a war torn world. Love letters. How he missed his family. Then back to earth, no job, Joan and Oboe joined at the hip. Disappointed would have been a mild description. Crushed was more like. Then two steps forward and one back. A job, a mortgage and a younger brother for Oboe. Death of his mum and a sister living over the brush. And the black dog. Days in bed with tummy ache. Duodenal ulcer the doctor said. Gave up smoking. Tins and tins of horrid white powder that didn’t quite mix with water. And the fits of violence. He wanted so much for the family, desperate that his sons should have a better chance.
The answer was in the levels. Qualifications that he’d never had. Oboe went off to grammar school and took the levels a year early and was away off to the Oxbridge exams before Dyce had taken the eleven plus. He’d no memory of how Oboe coped at home. Kept himself at it and out of the way was Dyce’s best guess. A good Liverpool degree followed by postgrad, a university teaching post, Hazel and two children. Now this. Dyce realised he didn’t know his older brother at all. A late midlife wobble. Was his university career a success? Had he achieved what he’d expected? You never asked questions. Either he knew everything there was to know and gave you the answer as if anyone should know it. Belittling that easily kept people at bay. Or you never asked because you knew he wouldn’t tell you.
Dyce’d to follow on. The same or different? Vulnerable and so wanted to please. Had to get out from under that long shadow. There was no future in soccer and cricket. Reg wouldn’t have it. Must be the levels. Started well enough with entry to grammar school. Good results in the first two years, and then he lost the plot. He learned the other lessons well enough. The ‘them and us’ lessons. Reg and his sister, Gladys, had never had much, solid labour and mistrustful of those that seemed well off. Don’t trust anyone with a posh accent. Never did a solid days work in their lives. Run things from the golf club. Big cars. Think they own the roads. A daily mantra, along with the sarcasm, ‘Bout time you knew your work as well as the adverts.’ It was strange. Reg didn’t like or trust them, but he’d wanted Dyce to become one.
Hazel talked about her early life. A farmer’s eldest daughter from rural Worcester. The twang was just there. Buses to school. Teacher training. Met Oboe when they were students.
Oboe’s best mate called for Dyce, ‘Would you like to go out for a drink.’ ‘Yes. okay.’ Five or six pints of Stella down The Hammer and Pincers left Dyce amnesic, even for the guy’s name. He said he’d already written a few words for the funeral. There was some talk of visiting Nepal, but Dyce said that whilst it was a great trip, he thought he’d found himself some time before. He wasn’t so sure now though.
Hazel and Dyce did not talk about Oboe dying. Instead they wondered what was going to happen when he woke up? Would he appreciate being resuscitated? He wasn’t there to give consent. How would he adjust to being alive?
Black humour was another way of coping. As long as he still lived.
‘He’s pinker than he’s been for years.’
‘He’ll have a massive hangover when he wakes up.’
‘What’s this f….. thing in my mouth? Jees, my throat’s like the bottom of a parrot’s cage.’
‘We could put a cigar in the ventilator and pour some scotch in one of his drips.’
‘Let’s move the furniture round in his room and decorate. Well we couldn’t wait for you, dad, you been asleep for so long. You remember you were worried about your seventieth birthday? Well don’t. You know seven year old James, your grandson. He’s in college now.’
‘Intensive Care should have its own car-park, after all there’s only eight beds and it is the most important ward in the hospital. We should have a special badge too, a uniform, separate dining-room.’
‘Do you think so?’
‘Well our own chip-shop anyway.’
Oboe kept cocking his wrist and kinking the blood pressure tube. The resultant bleep had an insistent bass rhythm. I wonder, thought Dyce, let’s listen for a tenor beep, maybe the ventilator. If we want the melody we will need something with a little flexibility. We’ll train your breathing Oboe. Could have a whole orchestra in here if we worked on it.
A vicar visited, a benign man with a smile and a beard.
‘I do a ward round.’
‘Yes course you do.’
He somehow craned his neck and pulled a strange face when Hazel said she was Oboe’s wife. Dyce wondered if he had wind, but he said it was part of his way of asking a question. How were they coping? He got wind again when Hazel said she was fine. Dyce said a sense of humour helped. The England cricket team will need some this winter in Australia. The vicar was away then on familiar ground, back at Trent Bridge. Hazel told him her husband wasn’t religious. He said a prayer anyway, it was his job after all.
No dull moments on intensive care. A regular turnover of patients, victims, inmates, whatever the collective noun is for the institutionalised.
Cristabel, a dotty old lady, alive and kicking, bruised and voluble, unsteady and muddled, went off on walks. ‘How did you get out of bed?’ Cristabel’s nurse couldn’t believe the umpteenth escape. Cristabel was there because attempts to find a bed in the hospital had failed. The nurses seemed used to it. Dyce labelled the Cristabels of this world the houdini syndrome. They could escape from anywhere, around and over cot sides, over the bed head, defying gravity and logic. Limbo dancing.
Another man was spark out in the next bed. The following morning he looked perfectly well without computer aids. Overdose said Dyce. Diabetic said Hazel, ‘I heard the nurse.’ Intensive Care is for ventilation, yet here was a guy there who was breathing on his own. They eventually found out why. Staff needed him for the telly and Liverpool’s champion’s league game against Valencia. Liverpool lost 2-0.
The staff members were institutionalised as well. The nurses were in blue, the doctors in green, the patients in skin and white, the vicar and head honcho in collar and tie.
Dyce met a fellow former student on the corridor, manicured, groomed and pin-striped, every inch the consultant physician and medical director. Once a piss-artist, he was now a comfortable member of the establishment, complete with a ‘good’ merit award. The rugby team they both played for back in the early seventies was going down the tubes. He’d just stepped down as president. ‘I’m only hanging on til I’m sixty to get the best financial deal. What are you doing here?’
‘Brother’s on Intensive Care.’
He walked away down the corridor, appearing important with important people to meet. Dyce was neither.
They performed a tracheostomy on the afternoon of day five, routine in cases requiring long periods of ventilation. Oboe was much lighter, starting to cough and move about. Chocolate coloured crap came up off the chest. His eyes opened and he recognised Hazel and Dyce. The ghost had returned. Hazel and Dyce smiled. The staff did too.
Dyce had to get back to work at some time, and needed to assess when. Day six was audit day for the top brass. A nurse reassured them, yes, we’ll make sure they know and someone will see you. Head honcho arrived and discussed the problems in front of Oboe, who was now fairly with it. Everything’s going well, liver and lungs are fine, just the heart and a struggle to combat infection. He slid round the answers as to when will the ventilation stop, how long will he need to be on Intensive Care.
‘I have appointments,’ said Dyce.
‘Keep them,’ he said without hesitation. So he could be direct about some things. Hazel and Dyce didn’t take to him, but there again he wasn’t there to be liked. ‘We’re going to stop the sedation and let him wake up,’ and he walked off.
After six days and ten hours Oboe woke despite enough drugs to sedate a large mammal, and the first hurdle was over. He wasn’t going to die that week. Dyce noted with a touch of bitterness that it was the family’s first medical success.
Oboe’s eyes fixed on Hazel, like a baby bonding with mum. What’s the matter? he asked. Well, everything, but Hazel explained in simple terms and repeated it several times.