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Maladies

 

1

Maybe it was reading a comment in a Thomas Bernhard novella recently that made me think I might be able to write about a friend’s health scare nearly a year ago, the death of the son of one of his work colleague’s a few months later and, very parenthetically, about a friend of a friend’s break-up. “The people who die without having known their illness, their fatal illness…” Bernhard writes, and I have often wondered whether perhaps the hypochondriac’s desire is to die having known their ailment, to anticipate it so that it cannot take them by surprise.

I had known Tom for around ten years, from the time when we worked together one summer teaching at a language school here in Edinburgh, over on the north side of the town near Stockbridge. He was several years older than me and a much more experienced teacher. Before marrying and having kids, he had taught English whilst travelling around Asia and Latin America. I would sometimes ask him to explain various rules of grammar that I had never learnt at school after the language centre, desperate for teachers that they could pay poorly, accepted me without the necessary qualifications, assuming a degree in English literature and a few published book reviews passed for expertise. He was as patient with me as he was with the children, and always seemed to know what he was talking about. Why was he teaching at the school I asked him one day, and he said he needed the extra money (he was a school teacher the rest of the time): I knew he had a family to support but he added that he also had a debt he wanted to pay off. During a trip to Mexico he became very ill, had no travel insurance, and called a doctor nevertheless. It was in the town of Oaxaca, which was warm during the day in winter but where the hotel rooms were cold and unheated in the evening. Anyway, he couldn’t stop shivering and vomiting for two days, and a doctor came, called an ambulance, and he stayed in the hospital for three days recuperating and picking up a big bill that his parents covered. The irony is, he added, that while he still had a debt to pay, he wasn’t sure if he still didn’t have the illness in his system, at least in his immune system. Where before he was never sick, almost never cold and would feel healthy, now he was frequently tired, would pick up minor colds, and half the time would take the bus where before he would always walk or cycle.

Back then when we taught together he was around thirty three, and while if someone had asked me to describe him, before what he told me, I would have said he was formidable and robust, with gnarly forearms and a strong jaw, with a straight back and springy movement, and thick, coarse hair; after it I might have been inclined to comment on the tired, often bloodshot eyes, the exhaustion evident in the lines on the forehead and the crow’s feet, and the flashes of grey in his hair.

Several years ago he split up from his wife and took a job in London. He wanted to get out of teaching anyway, he said, and got employed as an editor at a well-respected publishing house that printed work by a number of authors he had always liked. He would still regularly come up north to see his children, but I remember him telling me once that he felt like a child and not like a parent when he left. When he was young his parents would often be away at conferences and he would be looked after by an aunt who came and stayed in his parents’ absence. As they left he would feel abandoned, and here he was all those years later with the same feeling as he would leave behind his own children. He hoped that they both did and didn’t feel as he once had: of course he wanted them to miss him; but when he thought they might be feeling as emotionally destitute as he had felt, then guilt would accompany his loneliness.

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It was over loneliness and futility that the story he told me hinged, as about nine months ago he went for a check up at the doctor’s after feeling unwell, with his body tired when he woke up, and where he felt he was dragging an extra weight with him through the rest of the day. The doctor made an appointment for him with the nurse, and a few days later the doctor left a message on his answering machine saying that perhaps he should come in for further tests. Tom listened to the message many times that evening, trying to hear in the doctor’s inflection whether he was seriously ill, possibly dying. The next morning he phoned the doctor and said he had been worrying all night; what did the doctor mean? The doctor said he wasn’t sure, but there were some anomalies, he admitted, in the results, and that Tom’s white blood cell count was much lower than it should be. For all Tom’s grasp of grammar, he knew nothing about medicine, and he fretted over what this meant, finding internet searches alleviating his worries little.

Over the next few weeks he had more blood tests, and while nothing conclusive came out of them, he felt as if he were becoming more ill each day. He wanted to speak to a close friend or his family about it, but believed that he would be worrying them unduly: all he could say was that he felt ill and the doctors were worried. This was not quite the same thing as dying, even if he felt sure he happened to be. Perhaps had there been anybody he was close friends with in London he might have talked to them, but while he had three close friends in Scotland (including me), as well as his ex-wife and two kids, there was nobody in the city he was living in with whom he felt close, his parents were no longer alive, and he had no brothers or sisters. He wondered whether his isolation was indicative of his personality or the city’s and suspected it was both. During these few weeks he didn’t talk to anyone, and instead watched films about London that emphasized the loneliness of the place. He watched A Touch of Love and Wonderland, and a documentary that had just come out: a film about a woman who had been dead in her Wood Green flat for years before her body was found.

Tom was living in a flat not that far from Wood Green, along from Alexandra Palace, and as he would sometimes walk on a Saturday or Sunday afternoon from his flat, through Highgate down by Hampstead Heath and along Finchley High Road, where his parents had lived in a council house for a couple of years before he was born, so he wondered who was dying, who was not, who was lonely, who knew of people they could at that moment have talked to if they felt as he did. He also watched some film about illness, and read books like Love’s Work and Illness as Metaphor. He would joke to himself grimly that if he had three or more years left to live perhaps he should write a PhD on the subject. Yet during this period of about two months, he didn’t try and find out more himself about the illness he thought he might have, beyond that early internet trawl, and he wasn’t sure whether it was because he was so ignorant of medicine that his research wouldn’t have been any use to him, or whether he wanted more to find out how he felt rather than understand what he had.

During this period he had planned no trips up to Scotland to see his kids: he wanted to wait until he knew for certain that he was well or ill; living rather than dying. However, one evening after he got back from work he was so unable to sleep, and yet was so exhausted he knew he couldn’t go out for yet another walk, that he got into the car and started driving. He started with no plan, but when he passed Watford he knew he was going to drive to Scotland, hug his kids and fall asleep in one of the beds they would vacate as they went to school. This thought calmed him, but then seven hours later as he approached Edinburgh, he saw the reality of this scenario. There he would be at seven thirty in the morning knocking on his ex-wife’s door, with her and the kids preparing breakfast and getting ready for school (she taught primary), and they would worry more for his mental health than his perceived physical deterioration.

Instead he detoured slightly and pulled into the car park at the hospital at Little France, said to reception that he was very ill, and that he needed to see a doctor as quickly as possible. A harried looking figure came through and Tom didn’t know whether the doctor looked so tense because he thought a man was about to die on him in the reception, or that a patient in need of his care and attention had been briefly ignored while he could deal with Tom. But as the doctor sat down with him in a seat in the empty waiting room, the adjacent seating and the doctor’s soft consonants and mellifluous vowels made him feel calmer than he had felt when Tom saw the London doctor who was not unsympathetic but whose voice and desk somehow oppressed him. Tom had felt in the London doctor’s surgery that whether he lived or died wasn’t very important to the man who had a desk between them. When the London doctor said that he wanted to get to the bottom of this, it seemed like a problem that had nothing to do with Tom, nothing to do with life, let alone his own.

The doctor in Edinburgh said there was nothing to do but wait for the results, but added he shouldn’t take the tone of a doctor’s voice as a sign that he was terminally ill. The doctor laughed and said some of his colleagues sounded as if they were terminally ill when they talked, not their patients – sometimes it happens when you’re overworked, when you lack sleep. It was a comment empathic in its co-feeling: there the doctor was, near the end of a long shift, and there Tom was having arrived in Scotland after a sleepless night, and the doctor looked at his watch and said that was him finished. He asked Tom if he would like a coffee. Tom nodded, and the doctor said it was one of the paradoxes of his life: he needed a coffee to keep him awake as he drove home to the other side of Edinburgh in Stockbridge, but then needed to be sleepy enough when he arrived to fall asleep straight away. As Tom followed the doctor over to the coffee machine he was a child trailing a father, though the doctor would have been younger than he was. He almost asked for a hug, but hadn’t the doctor already given him a medical equivalent of one? Or rather not so much medical, as human within his medical role, and after the coffee, as Tom said goodbye, the handshake between them carried the intent of a meaningful gesture.

It was Friday morning, and Tom phoned work to say that he wasn’t well and would be taking the day off. He drove in the direction of the Pentlands, not far from where his ex-wife and children lived, and parked the car up by one of the reservoirs, sleeping for three hours as he pushed the seat back. He awoke after noon and the overcast, drizzly morning, with the sky granite grey, was now bright enough for him to feel pierced by sharp sunlight. He got out of the car and glanced up at a sky that was azure blue, with a few clouds only likely to interrupt the day’s sunshine for brief moments. He looked into the boot of the car, saw that he’d left his walking boots there from an exhausting, worried walk he’d done the previous weekend near Oxford, and, after putting them on, took with him a small rucksack that had a bottle of water and a couple of pieces of fruit in it. He walked over the Pentland hills, down past one of the reservoirs, and along to a popular inn for walkers. It was now after two, and, apart from the pieces of fruit, he hadn’t eaten since the previous evening. For the first time in weeks he ate like a man alive rather than one dying, and he thought of what he had eaten over the last week and reckoned he had received nourishment as if he were on a drip. Here he ate like he needed energy not only to survive, but to thrive also, and, after he finished, he took his coffee and sat outside in the sun. Going back inside he asked someone at the bar if they would refill his water bottle, and he walked back up and across the Pentlands. By the time he returned to the car he was exhausted from hours of walking and too little sleep, but it was a feeling of exhaustion he believed could be alleviated by rest. He fell asleep again in the car and awoke around seven, just as the sun began to set. He got out of the car, and looking around him, seemed to absorb the landscape as he had consumed his food: maybe he was dying but he felt alive.

He drove back down from the Pentlands and instead of going into the city, where he was going to book into a B&B, he carried on over to his e-wife’s. It was a house they had bought together ten years earlier, a detached bungalow, with large, glass windows that would have been violating if not located in so isolated a spot. The nearest neighbour was fifty yards away, the garden almost constituted land, and it was now made more private by the trees they had planted after they had bought it. Nevertheless with the faded light and the car headlights off, he could see into the kitchen and sitting room as he watched Nina and his two children, Mark and Catherine, making dinner and setting the table. This was how it would be in his absence, and this is how they were coping. He recalled when they were all living together there were often arguments when he got back from work: why was he late, why hadn’t he picked up the ingredients expected? As a family of four they didn’t work well, he knew, and it was odd looking in on them, believing he might be dying, and that they looked so well capable of living without him, that he felt happy for them, but suddenly terribly sad for himself. He started to cry as he sat there, the daylight completely faded, and it was not the terror of dying that horrified him at that moment, but his sense that he was very much alive, but not at all necessary. Who needed him? Neither the doctors he saw, nor the family he was spying on.

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As he told me this some months later, sitting in a pub round the corner from my flat off the Meadows, I wanted to find a gesture that would be equal to the doctor’s handshake, and yet knew that the friendship between us didn’t allow for the possibility of a hug. Instead I asked why didn’t he carry on into town, come over and stay at my place. We could have talked, talked as we were talking at that moment. He said maybe he would have if it were about his loneliness, but wasn’t it also about his impending death? No, to go to someone in desperation for one thing is perhaps possible, but for two?

As the tests had revealed that he had nothing serious, he also added that he never told his family at all about the illness he thought he might have, nor of the feelings of isolation, and the visit to Scotland. I asked why he was telling me this now; months later – why not months ago?  He told me that a few days’ earlier he had heard about a colleague of his at work: that his six year old son had passed away, dying of the very disease Tom was sure he had. The colleague had said nothing of this to anybody at work until his son died, and the stoicism he offered was due to the secret that the family had been withholding from the child: that he was going to die. They knew months earlier, probably around the same time that Tom knew that he was fine, and decided that the child would live his last few months aware he was very much loved but not at all aware that he wasn’t going to live. Of course, the boy would have known he was very sick, knew that he had a serious illness, but his parents convinced him that the illness would be temporary, and he would soon be well again.

Tom said he didn’t know this colleague very well, but he recalled one lunchtime sitting outside a cafe near where they worked and the man sat down at another table some distance away with his wife and his son and daughter, who looked like they might have been twins. This would have been before Tom’s own health scare, and his main feeling was one of sadness as he thought of the times in Edinburgh that Nina would occasionally join him for lunch with the kids, and how pleasurable his teaching mornings would seem knowing that he would soon be lunching with his family. On that day he was sitting watching another family enjoying a pleasure that was no longer his, and he had trouble keeping the emotion from showing itself as the colleague waved over. He waved back and saw himself as he believed the four of them must be seeing him: a man on his own, with no one to share his lunch hour. He hoped at that moment they would invite him over, and couldn’t quite see that maybe they didn’t do so not only because they would have wanted to be together themselves, but because he might have appeared to them happy with his own company: why would they suggest he sit with two bickering kids and parents who were calming them down? But that was what he wanted very badly – to be told to join them, to sit with them in the sunshine and feel part of a family for an hour as someone would be invited next to the hearth to escape from the cold.

It was the lazy metaphor he had in mind on that warm day, but as he talked to me about it he wondered whether it was so lazy after all. When he was shivering in Oaxaca there was nobody there either, but his parents promptly flew down from New York where they were at a conference, paid his bill and gave him the human warmth it took a while for him to find in his body again. Sitting in the cafe that lunchtime, his body was warmed by the sun, but his parents were no longer alive and his ex-wife and children were five hundred and fifty miles away. He said to himself that he would have done anything to swap places with his colleague that lunchtime, and of course he couldn’t but look on it now without terrifying irony; it was one wish that hadn’t come true, just as he hadn’t the illness the boy died from.

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I wondered after we parted, and he went back to the B&B in which he usually stayed when in Edinburgh visiting his kids, whether even if we did eventually find the cure for cancer, we would ever find the cure for feeling. DNA tests might be able to tell us when we are likely to die, but can it tell us when we will become lonely or emotionally devastated? A few weeks ago, as I was beginning to write the first draft of this story, I talked to another friend about it, and he told me about someone he knew. It was about four years ago, Robert was in his early thirties and had never before been in a relationship. He started seeing someone in the same discipline (genetics, interestingly), and they were together for a year. She wasn’t in love; Robert thought he had met the woman of his dreams and now that she had left it was turning his life into a nightmare. He wished they had never got together: before he was alone but he wasn’t lonely; now it was as though he were riddled with loneliness, an incapacitating sense of tenderness that should be going somewhere but now with nowhere to go was poisoning his body. The person had wished, the friend said, he could have predicted his emotional future and avoided the pain he was enduring. Four years on he was no better, and in some ways worse: there had been two suicide attempts, and time in an institution.

I thought then of the Bernhard quote that I had read not long before and wondered even if science will allow everybody to know their illness, their fatal illness, will we ever be able to know how to avoid pain that has nothing to do with the physical workings of the body, especially, but of that strange metaphorical organ, the heart? Tom knew of his illness in Mexico and went to a hospital where his parents visited and paid his bill. Years later he went again to a hospital on the other side of the world here in Edinburgh, sure of the severity of his malady, but believed he had nobody to rely upon and only people whom he might worry. Yet how can this image trouble me more than the thought of parents who have to bury their young child, why does this scene of a good friend reassured by a doctor more than five hundred miles from where he was living, but only a matter of miles from where his family and friends lived, cause me so much concern? It is obvious that I know Tom well and Tom’s colleague not at all, but I don’t think this is what moves me now, and moved me to write the story. A child lost his life not knowing his illness but knowing he was loved; where a grown man thought he knew his illness but somehow doubted the love of others, doubted whether he would be doing nothing more than troubling people unnecessarily about his condition. If it is true that the only things inevitable in life are death and taxes, that suggests loneliness can be avoided. Nothing it seems could have stopped the boy losing his life, but much could have been done to stop Tom from possessing such feelings of isolation, and yet what could have stopped a friend’s friend from collapsing after a collapsed relationship? I have no answer to such questions, but a thought does come to mind, and it concerns the speed with which we are learning things about our bodies, even our minds, but how little we seem able to learn about feelings, or to protect ourselves from them.

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After finishing the story one evening, I sent it as an attachment and asked Tom not at all to feel obliged to respond beyond a few words concerning whether or not he approved of its very existence: whether he felt at all violated by its presence. The next morning he replied saying that he had read the story, didn’t feel qualified to judge its literary merit as someone who was far from disinterested in this instance, and added that if only I had written it months before it might have assuaged him when he so needed it. The impossibility of time, he added, before adding: maybe that is why you writers write; to struggle with the paradoxes of the temporal. Perhaps he was correct, and I thought about the doctor who shook Tom’s hand after they talked and I wondered if maybe the combination of medical science and human warmth, no matter the complexity of the former and the simplicity of the latter, was all the man needed to do his job well. But a writer: what does he or she need to do their job well, and had Tom astutely encapsulated the problem in the paradoxes of time? The image I’m now left with, though, isn’t that of Tom at the hospital, but instead Tom looking on as his colleague and family have lunch, knowing that this family no longer exists as it once had, and that Tom’s doesn’t exist as it once had either. Yet in the colleague’s case the family, when the son became ill, knew of the illness, while the patient didn’t; in Tom’s the patient ‘knew’ but the family didn’t, and I now can’t easily separate the tragic from the apparently merely sad, though this story is the attempt to do exactly that. To know or not know one’s illness, that might be the question. But perhaps a reason to write isn’t only to work with the paradoxes of time, as Tom suggested, but also to search out the permutations of feeling that no doctor is qualified to diagnose and medical science is unlikely to resolve. It seems to me a position of hopeless removal, perhaps like Tom that early evening watching his family, and that afternoon watching someone else’s. It is to possess the feeling of a revenant: to be not so much ill as dead, on the outside looking in and looking on, and to possess a longing that perhaps no experience can cure.

 

©Tony McKibbin